Individual
EDWIN TRIA MALIJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Contact information
Practice address
9505 19TH AVE SE, SUITE 101, EVERETT, WA 98208-3853
(425) 379-8120
(425) 338-1789
Mailing address
9505 19TH AVE SE, SUITE 101, EVERETT, WA 98208-3853
(425) 379-8120
(425) 338-1789
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003917
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0115893
DEPT OF L&I PROVIDER ID#
WA
01
—
11362400
CIGNA&CAQH PROVIDER ID#
WA
01
—
2243189
AETNA HMO, QPOS ID#
WA
01
—
7076062
AETNA PPO,POS,EPO ID#
WA
05
—
7084650
—
WA
Enumeration date
01/22/2007
Last updated
07/09/2007
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