Individual provider Active NPI

Madison Alyssa Montano, PTA

  • Physical Therapy Assistant
  • Deer Park, WA
National Provider Identifier
1730038340
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA.P1.70125948 Issued in WA
Practice address
707 S Park St
Deer Park, WA 99006-7025
Phone
(509) 276-8811
Fax
(866) 629-4801
NPI assigned
Jan 26, 2026
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA.P1.70125948 WA Primary

Addresses

Primary practice location

707 S Park St
Deer Park, WA 99006-7025

Mailing address

501 N Arcadia Ave
Deer Park, WA 99006-5663
Phone (509) 276-8811

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
52901CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Park Physical Therapy Inc Past Accepting new patients
Revive Therapeutic Massage PastSince Nov 13, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1730038340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N ARCADIA AVE",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990065663",
            "telephone_number": "509-276-8811",
            "fax_number": "866-629-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S PARK ST",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990067025",
            "telephone_number": "509-276-8811",
            "fax_number": "866-629-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANO",
        "first_name": "MADISON",
        "middle_name": "ALYSSA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "PTA.P1.70125948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.