Healthcare Provider Details

I. General information

NPI: 1225894918
Provider Name (Legal Business Name): MCMULLIN FAMILY CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21707 103RD AVENUE CT E STE B201
GRAHAM WA
98338-8308
US

IV. Provider business mailing address

21707 103RD AVENUE CT E STE B201
GRAHAM WA
98338-8308
US

V. Phone/Fax

Practice location:
  • Phone: 253-847-7517
  • Fax: 253-847-7467
Mailing address:
  • Phone: 253-847-7517
  • Fax: 253-847-7467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW MCMULLIN
Title or Position: DOCTOR/OWNER
Credential: DC
Phone: 253-847-7517