Provider Demographics
NPI:1285016220
Name:SQUIERS, MONTE V A (MD)
Entity Type:Individual
Prefix:DR
First Name:MONTE
Middle Name:V A
Last Name:SQUIERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MONIQUE-TERES
Other - Middle Name:
Other - Last Name:SQUIERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:253-459-8009
Mailing Address - Fax:
Practice Address - Street 1:311 S L ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3720
Practice Address - Country:US
Practice Address - Phone:253-403-1507
Practice Address - Fax:253-403-1641
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA168474207X00000X, 207XP3100X
WAMD61459681207XP3100X
MI4301108208207X00000X
UT12229851-1205207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery