Provider Demographics
NPI:1962203851
Name:JENIA MALYSH PLLC
Entity type:Organization
Organization Name:JENIA MALYSH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALYSH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP, PMHNP-BC
Authorized Official - Phone:206-333-8258
Mailing Address - Street 1:918 S HORTON ST APT 1018
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134-1513
Mailing Address - Country:US
Mailing Address - Phone:206-333-8258
Mailing Address - Fax:206-649-7182
Practice Address - Street 1:918 S HORTON ST APT 1018
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-1513
Practice Address - Country:US
Practice Address - Phone:206-333-8258
Practice Address - Fax:206-649-7182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1275154320OtherNPI