Provider Demographics
NPI:1225642366
Name:MONTUFAR, JOSHUA STEVEN
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:STEVEN
Last Name:MONTUFAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 WHISPER LN SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1139
Mailing Address - Country:US
Mailing Address - Phone:253-341-7051
Mailing Address - Fax:
Practice Address - Street 1:6208 WHISPER LN SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-1139
Practice Address - Country:US
Practice Address - Phone:253-341-7051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-05
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC54019171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty