Individual
AILEEN HIDALGO MONPONBANUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 S CARR RD, SUITE 100, RENTON, WA 98055-5866
(425) 227-3700
(425) 227-3106
Mailing address
601 S CARR RD, SUITE 100, RENTON, WA 98055-5866
(425) 227-3700
(425) 227-3106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00041464
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8370397
—
WA
Enumeration date
08/26/2005
Last updated
05/25/2021
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