Provider Demographics
NPI:1376322008
Name:MONTANO, MARIO CESAR (MSW)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:CESAR
Last Name:MONTANO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 E MAGNESIUM RD APT 260
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-7304
Mailing Address - Country:US
Mailing Address - Phone:509-431-4692
Mailing Address - Fax:
Practice Address - Street 1:510 E AMENDE DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:WA
Practice Address - Zip Code:99159-7003
Practice Address - Country:US
Practice Address - Phone:509-982-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA614739251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical