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Contact Information

MALLORY R MUMMA, ARNP
209 LILLY RD NE STE B
OLYMPIA, WA98506-5030
 Phone: 360-413-8250
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gerontology

363LG0600X 50 Nurse Practitioner
 

Gastroenterology

163WG0100X
Indicates primary specialty

NPI Profile & details for MALLORY R MUMMA · (Female)

NPI # 1801783402
Status Active
Credentials ARNP (Advanced Registered Nurse Practitioner)
Entity Individual
Enumeration date 06/18/2025
Last updated 08/11/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • WA License # 60412207
  • WA License # AP70030539
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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