Michael Stephen Mallahan, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

LD0001117 Issued in WA

Practice address

15906 Mill Creek Blvd
Suite 102
Mill Creek, WA 98012-1797

Phone

(425) 225-2626

Fax

(425) 225-2634

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1194720367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15906 MILL CREEK BLVD",
            "address_2": "SUITE 102",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121797",
            "telephone_number": "425-225-2626",
            "fax_number": "425-225-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15906 MILL CREEK BLVD",
            "address_2": "SUITE 102",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121797",
            "telephone_number": "425-225-2626",
            "fax_number": "425-225-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAHAN",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "WA",
            "license": "LD00001117",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD0001117",
            "primary": true
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "WA",
            "license": "LD00001117",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "WA",
            "license": "LD00001117",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7089592",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR & IND.",
            "identifier": "117072",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE ID #",
            "identifier": "MA5615",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Ann Magder, LMFT
• Gary James Maguire, MSPT
• Sarah Youssef Makari
• Joy Makdisi, MD
• Navid David Malakouti, M.D.
• Kimberlee Mansfield, FNP-BC
• Jenny Lynn Mapes, L.M.T.
• Shane D Marquardt
• Adriane Meryl Martin
• Evan Thomas Martina, DPT

• Audiologist in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Audiologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.