Provider Demographics
NPI:1023162401
Name:PULLIN, HAL LYNN (MA)
Entity type:Individual
Prefix:MR
First Name:HAL
Middle Name:LYNN
Last Name:PULLIN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 NTH 17TH PLACE
Mailing Address - Street 2:
Mailing Address - City:MT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273
Mailing Address - Country:US
Mailing Address - Phone:360-424-8426
Mailing Address - Fax:
Practice Address - Street 1:117 NTH 1ST #55
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273
Practice Address - Country:US
Practice Address - Phone:360-421-4858
Practice Address - Fax:360-336-2521
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004535103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist