Provider Demographics
NPI:1164464517
Name:MALAKHOVA, SHERI W (MD)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:W
Last Name:MALAKHOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-304-8431
Mailing Address - Fax:
Practice Address - Street 1:805 FRONT ST S
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-4205
Practice Address - Country:US
Practice Address - Phone:425-392-1271
Practice Address - Fax:425-557-5563
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAM.D.60191687207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID804062900Medicaid
ID804062900Medicaid
WAG8915679Medicare PIN