Individual provider Active NPI

Mallory Rose Beach, ARNP

  • Family Nurse Practitioner
  • Camano Island, WA
National Provider Identifier
1689354466
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61464135 Issued in WA
Practice address
127 NE Camano Dr Ste a
Camano Island, WA 98282-8732
Phone
(360) 387-5398
Fax
(360) 629-1644
NPI assigned
Jul 18, 2023
Last updated
May 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61464135 WA Primary

Addresses

Primary practice location

127 NE Camano Dr Ste a
Camano Island, WA 98282-8732

Mailing address

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 428-2500

Other practice location 1

9631 269th St NW
Stanwood, WA 98292-8071
Phone (360) 629-1600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbeach47663@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230918003856 WA Practitioner - Nurse Practitioner 8123482569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

127 NE Camano Dr
Suite A117
Camano Island, WA 98282-8732
Phone (360) 387-5398

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 26, 2024 Accepting new patients
Community Health Center of Snohomish County CurrentSince Aug 7, 2023 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 26, 2024 Accepting new patients
Community Health Center of Snohomish County CurrentSince Aug 7, 2023 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 26, 2024 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

326 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2144

127 NE Camano Dr
Ste A
Camano Island, WA 98282
Phone (360) 387-5398

127 NE Camano Dr
Ste A117
Camano Island, WA 98282
Phone (360) 387-5398

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

9631 269th St NW
Stanwood, WA 98292
Phone (360) 629-1600

Organizations & group practices 7

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

Hospital & facility affiliations 2

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": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1689354466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744126",
            "telephone_number": "360-428-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NE CAMANO DR STE A",
            "city": "CAMANO ISLAND",
            "state": "WA",
            "postal_code": "982828732",
            "telephone_number": "360-387-5398",
            "fax_number": "360-629-1644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9631 269th St NW",
            "address_purpose": "LOCATION",
            "city": "Stanwood",
            "state": "WA",
            "postal_code": "982928071",
            "country_code": "US",
            "telephone_number": "360-629-1600",
            "fax_number": "360-629-1644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEACH",
        "first_name": "MALLORY",
        "middle_name": "ROSE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61464135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbeach47663@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "127 NE Camano Dr Ste A",
            "city": "Camano Island",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982828732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camano Island, WA

Sources for this page

Verify at the official NPI Registry.