KYLIE MALSTROM (DNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1205687621

KYLIE MALSTROM (DNP) is a healthcare provider. based in Tulalip, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. AP61576793 (WA). The NPI Number for KYLIE MALSTROM (DNP) is 1205687621

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KYLIE MALSTROM (DNP)
NPI
1205687621
Phone
(253) 833-7444
Address
7520 TOTEM BEACH RD
Enumeration Date
1 April 2024
Last Update Date
24 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3607164511
Graduation Year
2024 (2 years ago)
PAC ID
1850815499
Group Practice PAC ID
7719879782
Professional Enrollment ID
I20250702002540
Address ID
WA982716160TU7520XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for KYLIE MALSTROM (DNP)

  • 7520 TOTEM BEACH RD

    TULALIP, WA 982716160

    Phone: (253) 833-7444

    Fax: (360) 716-0754

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250404001718INurse PractitionerTXTBD
I20250702002540INurse PractitionerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98271)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719879782View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeID
Nurse PractitionerNC
Endocrinology, Internal MedicineWA
-WA
Marriage And Family TherapistWA
O P T O M E T R YWA
Nurse PractitionerWA
Physician AssistantWA
-WA
-WA

Reviews

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Frequently asked questions

Is KYLIE MALSTROM (DNP) listed with a National Provider Identifier?
Yes — KYLIE MALSTROM (DNP) has NPI 1205687621 on file in the registry.
Would KYLIE MALSTROM (DNP) appear as active to a payer?
You can treat KYLIE MALSTROM (DNP) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe KYLIE MALSTROM (DNP)'s focus?
For KYLIE MALSTROM (DNP), the primary taxonomy reads as Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Washington is KYLIE MALSTROM (DNP) registered?
Use Tulalip, Washington as the headline location for KYLIE MALSTROM (DNP) here.
Can I trust this NPI listing for KYLIE MALSTROM (DNP)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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