Edwin Tria Malijan, RPT | |
9505 19th Ave Se, Suite 101, Everett, WA 98208-3853 | |
(425) 379-8120 | |
(425) 338-1789 |
Full Name | Edwin Tria Malijan |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 9505 19th Ave Se, Everett, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588718027 | NPI | - | NPPES |
2243189 | Other | WA | AETNA HMO, QPOS ID# |
7084650 | Medicaid | WA | |
11362400 | Other | WA | CIGNA&CAQH PROVIDER ID# |
0115893 | Other | WA | DEPT OF L&I PROVIDER ID# |
7076062 | Other | WA | AETNA PPO,POS,EPO ID# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT00003917 (Washington) | Primary |
Provider Name | Mountlake Sports & Physical Therapy Ps |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1528331402 PECOS PAC ID: 0840645230 Enrollment ID: O20231004001992 |
Mailing Address | Practice Location Address |
---|---|
Edwin Tria Malijan, RPT 9505 19th Ave Se, Suite 101, Everett, WA 98208-3853 Ph: (425) 379-8120 | Edwin Tria Malijan, RPT 9505 19th Ave Se, Suite 101, Everett, WA 98208-3853 Ph: (425) 379-8120 |
Mr. Emerson Muhat, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1919 112th St Sw, Everett, WA 98204 Phone: 425-513-1600 | |
Dr. Simon Jinhung Li, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 13410 Highway 99 Ste 204, Everett, WA 98204 Phone: 425-742-7300 | |
Shannon E Long, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3927 Rucker Ave, Everett, WA 98201 Phone: 425-339-5419 | |
Scott Louis Sheffler, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2930 Maple St, Everett, WA 98201 Phone: 425-261-1500 | |
Brittany Kay Leung, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 Pacific Ave Ste 130, Everett, WA 98201 Phone: 425-535-0475 | |
Natalie Brenda Lew, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 12811 8th Ave W, A-205, Everett, WA 98204 Phone: 425-348-1259 Fax: 425-348-3071 | |
Charlene Wu Sapida, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 919 128th St Sw, Everett, WA 98204 Phone: 425-347-8614 Fax: 425-348-6986 |