Healthcare Provider Details

I. General information

NPI: 1568325165
Provider Name (Legal Business Name): AIDAN MALALANG DPT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 140TH ST S STE 700
TACOMA WA
98444-4549
US

IV. Provider business mailing address

223 140TH ST S STE 700
TACOMA WA
98444-4549
US

V. Phone/Fax

Practice location:
  • Phone: 253-531-5645
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.PT.70067827
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: