Individual
DR. TARA L. MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1400 E. KINCAID STREET, MOUNT VERNON, WA 98274-4127
(360) 428-6434
(360) 848-4233
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 425-6485
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP60329003
WA
207P00000X
Emergency Medicine Physician
OT011765
PA
Other
Enumeration date
05/16/2007
Last updated
04/15/2016
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