Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | MD60842674 | WA |
Y | 208200000X | Surgeon | MD60842674 | WA |
Y | 208600000X | Surgeon | MD60842674 | WA |
NPI | 1477992949 |
---|---|
Provider Name | Dr. Peter Joseph Montano Edpao |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2013 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1477992949 | (05) | WA |