Healthcare Provider Details

I. General information

NPI: 1003698002
Provider Name (Legal Business Name): MALACHI C PARTEE MEDICAL ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 TACOMA AVE S
TACOMA WA
98402-1903
US

IV. Provider business mailing address

1305 TACOMA AVE S
TACOMA WA
98402-1903
US

V. Phone/Fax

Practice location:
  • Phone: 253-396-5800
  • Fax:
Mailing address:
  • Phone: 253-396-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: