Provider Demographics
NPI:1982056131
Name:MALONE PEDIATRICS
Entity Type:Organization
Organization Name:MALONE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC NURSE PRACTITIONER/ PRESI
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, PHD
Authorized Official - Phone:360-535-9404
Mailing Address - Street 1:11106 NE TULIN RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-9257
Mailing Address - Country:US
Mailing Address - Phone:360-535-9404
Mailing Address - Fax:
Practice Address - Street 1:11106 NE TULIN RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-9257
Practice Address - Country:US
Practice Address - Phone:360-535-9404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005187208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty