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NPI Code Detail

MEDICARE: MALLORY ANDERSON

MEDICARE: MALLORY ANDERSON
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
1101Y00000XCounselorWA

General Provider Information

NPI Number : 1205396413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY ANDERSON
Provider Business Mailing Address
First Line : 4526 FEDERAL AVE
Second Line :
City : EVERETT
State : WA
Zip : 98203-2132
Country : US
Telephone Number : 425-349-6200
Fax Number :
Provider Business Practice Location Address
First Line : 4526 FEDERAL AVE
Second Line :
City : EVERETT
State : WA
Zip : 98203-2132
Country : US
Telephone Number : 425-349-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2019
Last Update Date : 04/06/2026

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Directions to “ MALLORY ANDERSON ” Practice Location

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