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Individual

MR. JOSHUA JASON MONTEMAYOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
19200 N KELSEY ST, MONROE, WA 98272-1431
(360) 794-4790
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60315504
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346594280
WA
Enumeration date
10/30/2012
Last updated
05/25/2021
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