Healthcare Provider Details

I. General information

NPI: 1790676468
Provider Name (Legal Business Name): NHU MAI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 SW MARCIA DR
PULLMAN WA
99163-5256
US

IV. Provider business mailing address

PO BOX 881
PULLMAN WA
99163-0881
US

V. Phone/Fax

Practice location:
  • Phone: 509-720-8653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number60691500
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: