Active NPI
Paul G. Montes, MD
- Family Medicine Physician
- Lynnwood, WA
National Provider Identifier
1407058282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00017521
- Practice address
- 20200 54TH Ave W
Lynnwood, WA 98036-6318 - Phone
- (425) 672-6400
- NPI assigned
- Jun 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00017521 | WA | Primary |
Addresses
Primary practice location
20200 54TH Ave W
Lynnwood, WA 98036-6318
Mailing address
PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8420101 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00017521 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1407058282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34584",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241584",
"telephone_number": "509-241-7349",
"fax_number": "509-241-7628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20200 54TH AVE W",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366318",
"telephone_number": "425-672-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTES",
"first_name": "PAUL",
"middle_name": "G.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00017521",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8420101",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.