Basic Information
| Provider Information | |||||||||
| NPI: | 1639172935 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MULLER | ||||||||
| FirstName: | LUCIA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2116 EAST SECTION STREET | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982749124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604281700 | ||||||||
| FaxNumber: | 3608484350 | ||||||||
| Practice Location | |||||||||
| Address1: | 2116 EAST SECTION STREET | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982749124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604281700 | ||||||||
| FaxNumber: | 3608484350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2005 | ||||||||
| LastUpdateDate: | 02/25/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD00038857 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 167956 | 01 | WA | L&I | OTHER | 8268930 | 05 | WA | MEDICAID |