Provider Demographics
NPI:1619308160
Name:MONCE, RICK (MA)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:MONCE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:MONCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:300 NE GILMAN BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2941
Mailing Address - Country:US
Mailing Address - Phone:206-428-1955
Mailing Address - Fax:
Practice Address - Street 1:300 NE GILMAN BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2941
Practice Address - Country:US
Practice Address - Phone:206-428-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60191650106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist