Maria Lydia Montenegro, MD
General Practice in Medical Lake, WA. Individual provider (NPI-1).
NPI number1619005014
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1619005014
- Entity type
- Individual (NPI-1)
- Name
- Maria Lydia Montenegro
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 28, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | MD00021239 | WA | Yes |
Practice location
2320 Salnave RdLakeland Village
Medical Lake, WA 99022
Phone 509-299-1836 · Fax 509-299-1906
Mailing address
2320 Salnave RdLakeland Village
Medical Lake, WA 99022
Phone 509-299-1836 · Fax 509-299-1906
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