NPIMap

Individual provider Active NPI

Erin M. Mallery, PA-C

  • Physician Assistant
  • Marysville, WA
National Provider Identifier
1396149753
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60511982 Issued in WA
Practice address
2901 174TH St NE
Marysville, WA 98271-4743
Phone
(360) 454-1900
Fax
(360) 454-1991
NPI assigned
Oct 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.60511982 WA
Physician Assistant 363A00000X PA60511982 WA Primary

Addresses

Primary practice location

2901 174TH St NE
Marysville, WA 98271-4743

Mailing address

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

Other practice location 1

314 Martin Luther King Jr Way
Tacoma, WA 98405-4250
Phone (253) 403-7257

Other identifiers 1

IdentifierTypeStateIssuer
1122012OtherNCCPA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141208002290 WA Practitioner - Physician Assistant 2163419235 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1201 N 175TH St
Shoreline, WA 98133-5064
Phone (425) 339-4299

1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966

2600 Compass Rd
Glenview, IL 60026-8001

3130 Ellis St
Bellingham, WA 98225-1904
Phone (360) 734-4404

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442

528 Myrtle St
La Conner, WA 98257-4716
Phone (360) 466-3136

912 32ND St
Suite a
Anacortes, WA 98221-3473
Phone (360) 466-3136

Hospital & facility affiliations

  • Eden Home Health Home health agency, Bellingham, WA, CCN 507105
  • Signature Healthcare at Home Home health agency, Burlington, WA, CCN 507100
  • Island Hospital Hospital, Anacortes, WA, CCN 500007
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.60511982WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Sep 14, 2020 Accepting new patients
Multicare Health System CurrentSince Dec 1, 2014 Accepting new patients
Optum Care Washington PLLC CurrentSince Sep 14, 2020 Accepting new patients
Multicare Health System CurrentSince Dec 1, 2014 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Mar 17, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Mar 17, 2019 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
Public Hospital District No 2 Skagit County Washington Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2901 174th St NE
Marysville, WA 98271
Phone (360) 454-1900

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: emallery28896@direct.tecmc.com

Organizations & group practices 11

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1396149753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054265",
            "telephone_number": "253-596-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 174TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982714743",
            "telephone_number": "360-454-1900",
            "fax_number": "360-454-1991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054250",
            "country_code": "US",
            "telephone_number": "253-403-7257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLERY",
        "first_name": "ERIN",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA.60511982",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60511982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1122012",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "314 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.