Provider Demographics
NPI:1730065574
Name:MULLEN, MANON MIHO
Entity type:Individual
Prefix:MS
First Name:MANON
Middle Name:MIHO
Last Name:MULLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 GUARDFISH ST
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98315-2001
Mailing Address - Country:US
Mailing Address - Phone:206-827-1466
Mailing Address - Fax:
Practice Address - Street 1:2020 GUARDFISH ST
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98315-2001
Practice Address - Country:US
Practice Address - Phone:206-827-1466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians