Individual
RALPH A. MONTEAGUDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
214 SW MAIN ST., WILBUR, WA 99185-0582
(509) 647-5321
(509) 647-2238
Mailing address
100 3RD ST, STE 1, DAVENPORT, WA 99122-5008
(509) 725-7501
(509) 725-7504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001334
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199002
DEPT. OF L & I
WA
05
—
7101132
—
WA
05
—
7117450
—
WA
05
—
8132342
—
WA
01
—
CJ6525
MEDICARE RAILROAD
WA
01
—
P00229831
MEDICARE RAILROAD
WA
Enumeration date
06/14/2006
Last updated
03/07/2023
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