Malia M Ethredge

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

120 W Mission Ave
Spokane, WA 99201-2358

Phone

(509) 326-4643

Fax

(509) 326-4802

NPI assigned

Dec 11, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1801294517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MISSION AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012358",
            "telephone_number": "509-326-4643",
            "fax_number": "509-326-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MISSION AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012358",
            "telephone_number": "509-326-4643",
            "fax_number": "509-326-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHREDGE",
        "first_name": "MALIA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Community Health Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.