Provider Demographics
NPI:1275124695
Name:ALDEN, MARYALLYN (PA-C)
Entity Type:Individual
Prefix:
First Name:MARYALLYN
Middle Name:
Last Name:ALDEN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3130 SQUALICUM PKWY
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1940
Mailing Address - Country:US
Mailing Address - Phone:360-671-4509
Mailing Address - Fax:360-756-5184
Practice Address - Street 1:3130 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1940
Practice Address - Country:US
Practice Address - Phone:360-671-4509
Practice Address - Fax:360-756-5184
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2023-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA61126244363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant