Provider Demographics
NPI:1548590474
Name:MONTOYA-ALM, ANA MARIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:MONTOYA-ALM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:MARIA
Other - Last Name:MONTOYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1728 W MARINE VIEW DR
Mailing Address - Street 2:STE 110
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2094
Mailing Address - Country:US
Mailing Address - Phone:425-258-4041
Mailing Address - Fax:
Practice Address - Street 1:1330 ROCKEFELLER AVE
Practice Address - Street 2:STE 400
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1684
Practice Address - Country:US
Practice Address - Phone:425-261-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60115638363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8888599Medicare UPIN