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NPI Code Detail

MEDICARE: OURANIA B MALLIRIS M.D.

MEDICARE: OURANIA B MALLIRIS M.D.
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
1208000000XPediatrics PhysicianMD00017659WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821096009
Entity Type Code : Individual
Provider Name (Legal Business Name) : OURANIA B MALLIRIS M.D.
Provider Business Mailing Address
First Line : 7554 15TH AVE NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-5409
Country : US
Telephone Number : 203-783-9300
Fax Number : 206-789-8404
Provider Business Practice Location Address
First Line : 7554 15TH AVE NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-5409
Country : US
Telephone Number : 203-783-9300
Fax Number : 206-789-8404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 05/22/2008

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Directions to “ OURANIA B MALLIRIS M.D.” Practice Location

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