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Individual
MS. SHAE NOELLE MONTEGNA
Active
Individual
MS. SHAE NOELLE MONTEGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00727
OR
363AM0700X
Medical Physician Assistant
OR PA00727
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2003546
—
WA
05
—
500606847
—
OR
01
—
P01252763
RR MEDICARE (PH&S)
OR
Enumeration date
11/02/2006
Last updated
06/25/2024
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