Montenegro, Maria Lydia
Montenegro, Maria Lydia is an sole proprietor health care provider with primary practice located at 2320 Salnave Rd Lakeland Village, Medical Lake WA 99022. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Montenegro, Maria Lydia can be contacted via phone (509) 299-1836.Contact Information
Primary practice address
2320 Salnave Rd Lakeland Village
Medical Lake WA 99022
Phone: (509) 299-1836
Fax: (509) 299-1906
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MD00021239 | Washington |
Profile Details
| NPI number | 1619005014 |
|---|---|
| LBN Legal business name | Montenegro, Maria Lydia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 28th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619005014 | NPPES |
| Washington | MEDICAID | 1056597 |
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