Provider Demographics
NPI:1356461412
Name:MONTALAND MCGRATH CHIROPRACTIC CENTER, PS, INC
Entity Type:Organization
Organization Name:MONTALAND MCGRATH CHIROPRACTIC CENTER, PS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXIE
Authorized Official - Middle Name:ESTELLE
Authorized Official - Last Name:MONTALAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-641-2527
Mailing Address - Street 1:14405 NE 20TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3710
Mailing Address - Country:US
Mailing Address - Phone:425-641-2527
Mailing Address - Fax:
Practice Address - Street 1:14405 NE 20TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3710
Practice Address - Country:US
Practice Address - Phone:425-641-2527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034383111N00000X
WACH00003532111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB04013Medicare ID - Type Unspecified