Provider Demographics
NPI:1922153469
Name:MALU, HILLARY (LMP)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:MALU
Suffix:
Gender:F
Credentials:LMP
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 1067
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-1067
Mailing Address - Country:US
Mailing Address - Phone:206-755-5239
Mailing Address - Fax:360-221-4190
Practice Address - Street 1:5017 196TH ST SW
Practice Address - Street 2:STE. 209
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6123
Practice Address - Country:US
Practice Address - Phone:206-755-5239
Practice Address - Fax:360-221-4190
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist