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General NPI Number Information
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NPI Number | 1124779780
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Entity Type | Individual
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Provider Name | MR. MALCOLM LIZZAPPI
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Gender | Male
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Dates
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Enumeration Date | 01/15/2022
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1959 NE PACIFIC ST BOX 356540
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City | SEATTLE
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State | WA
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Zip | 98195-0005
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Country | US
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Telephone | 206-543-2474
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Fax |
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Provider Business Mailing Address
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Address Line | 733 N BROADWAY STE 147H
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City | BALTIMORE
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State | MD
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Zip | 21205-1832
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Country | US
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Telephone | 410-955-3080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ML61680643
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License Number State | WA
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