Individual
TINA MALM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2205 BROADWAY, EVERETT, WA 98201-2321
(888) 227-3312
(425) 259-8630
Mailing address
PO BOX 2928, PORTLAND, OR 97208-2928
(888) 227-3312
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
324081
LA
363AM0700X
Medical Physician Assistant
0110002949
VA
Other
Enumeration date
05/21/2009
Last updated
11/13/2024
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