Individual
MARIA LYDIA MONTENEGRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2320 SALNAVE RD, LAKELAND VILLAGE, MEDICAL LAKE, WA 99022
(509) 299-1836
(509) 299-1906
Mailing address
2320 SALNAVE RD, LAKELAND VILLAGE, MEDICAL LAKE, WA 99022
(509) 299-1836
(509) 299-1906
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00021239
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1056597
—
WA
Enumeration date
02/28/2007
Last updated
07/08/2007
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