Healthcare Provider Details

I. General information

NPI: 1497825673
Provider Name (Legal Business Name): COLLEEN MULVIHILL PACEM ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COLLEEN D. MULVIHILL

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22850 NE 8TH ST SUITE 103
SAMMAMISH WA
98074-7256
US

IV. Provider business mailing address

PO BOX 34036
SEATTLE WA
98124-1036
US

V. Phone/Fax

Practice location:
  • Phone: 425-898-0305
  • Fax: 425-898-8825
Mailing address:
  • Phone: 425-899-3292
  • Fax: 425-899-3269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00160922
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAP30007552
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30007552
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: