Patrick William Montgomery, PHD CLIN PSYCH

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY0810009447 Issued in VA

Practice address

9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(253) 968-4851

NPI assigned

Jun 22, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1750067971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "PATRICK",
        "middle_name": "WILLIAM",
        "credential": "PHD CLIN PSYCH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "PSY0810009447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donnetta Eyvonne Montgomery, LMP
• Elizabeth Nell Montgomery, ARNP
• Grace Marie Montgomery
• Lindsay Montgomery
• Margaret Noel Montgomery
• Shawn Montgomery
• Tana Y Montgomery
• Jonathan David Monti, MPAS, PA-C
• Zachary Graham de Vahl Montoya Lewis
• Mihee Mickey Montstream, ARNP

• Clinical Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.