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General NPI Number Information
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NPI Number | 1447250410
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Entity Type | Organization
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Legal Business Name | MOLLER ENTERPRISES INC
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5998 HIGHWAY 291 #5
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City | NINE MILE FALLS
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State | WA
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Zip | 99026-9573
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Country | US
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Telephone | 509-468-4770
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Fax | 509-468-4659
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Provider Business Mailing Address
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Address Line | 13013 W SUNNYVALE DR
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City | NINE MILE FALLS
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State | WA
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Zip | 99026-9319
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Country | US
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Telephone | 509-468-4770
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Fax | 509-468-4659
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. MARY DENISE MOLLER
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Credential | MSN, ARNP, BC, ND(C)
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Telephone | 509-468-4770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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