MEDICARE: MALEDE E. MENGISTU MDCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ML70095012	WA

General Provider Information

NPI Number	:	1053269134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALEDE E. MENGISTU MDCE

Provider Business Mailing Address
First Line	:	2219 RIMLAND DR
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-8660
Country	:	US
Telephone Number	:	253-922-4027
Fax Number	:	844-222-0800

Provider Business Practice Location Address
First Line	:	2219 RIMLAND DR
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-8660
Country	:	US
Telephone Number	:	253-922-4027
Fax Number	:	844-222-0800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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