Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | CA | |
N | 2251X0800X | Physical Therapist - Orthopedic | 32860 | FL |
NPI | 1053830182 |
---|---|
Provider Name | Natalie Moncayo |
First Address | Redmond, WA 98052-1542 |
Second Address | Redmond, WA 98052-1542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2017 |
Last Update Date | 15/04/2021 |