Provider Demographics
NPI:1952306490
Name:MALONEY, ERIN MICHELLE (PA-C, MMS)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MICHELLE
Last Name:MALONEY
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE #4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:5580 NORDIC PL
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9138
Practice Address - Country:US
Practice Address - Phone:360-384-1511
Practice Address - Fax:360-384-5758
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3059363AM0700X
WAPA60095612363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1219MAOtherREGENCE
WA7557574OtherCIGNA
WA8555484Medicaid
WA252736OtherL&I
WA7557574OtherCIGNA
WAG8884453Medicare PIN