Tina Malm, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

324081 Issued in LA

Practice address

2205 Broadway
Everett, WA 98201-2321

Phone

(888) 227-3312

Fax

(425) 259-8630

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014
• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tmalm571815@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Health & Services- Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Washington

  • Internal Medicine Physician
  • Monroe, WA
  • NPI 1770734881
  NPD
• Providence Health & Services - Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1013169507
  NPD (past)
• Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)
• West Virginia Surgical Institute

  • Surgery Physician
  • Beckley, WV
  • NPI 1710273313
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services-Wa

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation
• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1003041898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2928",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082928",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012321",
            "telephone_number": "888-227-3312",
            "fax_number": "425-259-8630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1668 US-51 N",
            "address_purpose": "LOCATION",
            "city": "Ponchatoula",
            "state": "LA",
            "postal_code": "70454",
            "country_code": "US",
            "telephone_number": "985-401-4022",
            "fax_number": "985-401-4023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALM",
        "first_name": "TINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002949",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "324081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glory Malenga
• Edwin Tria Malijan, R.P.T.
• Amy Malinowski, DPT
• Dane Mallahan
• Melissa Mallory
• Tyra L Malmborg Okelley, PT
• Jessica Nichole Adline Malone, AA, PEER
• Dana Mam, PHARMD
• Neil Mamaril
• Grace Henson Manabat, OTR/L

• Physician Assistant in Everett, WA
• Providers in Everett, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.