Active NPI
David Maligro, PA-C
- Physician Assistant
- Longview, WA
National Provider Identifier
1366492795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10003539
- Practice address
- 625 9TH Ave
Ste 210
Longview, WA 98632-2465 - Phone
- (360) 501-3400
- Fax
- (360) 423-6862
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10003539 | WA | Primary |
Addresses
Primary practice location
625 9TH Ave
Ste 210
Longview, WA 98632-2465
Mailing address
625 9TH Ave
Ste 210
Longview, WA 98632-2465
Phone (360) 501-3400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0198040 | Other | WA | LABOR & INDUSTRIES |
| 8345068 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10003539 | WA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1366492795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 9TH AVE",
"address_2": "STE 210",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322465",
"telephone_number": "360-501-3400",
"fax_number": "360-423-6862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 9TH AVE",
"address_2": "STE 210",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322465",
"telephone_number": "360-501-3400",
"fax_number": "360-423-6862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIGRO",
"first_name": "DAVID",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10003539",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0198040",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8345068",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.