Provider Demographics
NPI:1285188177
Name:MALAI, NICK SATHYA-THON (PHARMD)
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:SATHYA-THON
Last Name:MALAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32018 52ND AVE S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-3872
Mailing Address - Country:US
Mailing Address - Phone:253-335-9022
Mailing Address - Fax:
Practice Address - Street 1:33702 21ST AVE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-7762
Practice Address - Country:US
Practice Address - Phone:253-952-0133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60645607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist