Provider Demographics
NPI:1679685689
Name:MCMONAGLE, JOSEPH PATRICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:MCMONAGLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ALIDA ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2160
Mailing Address - Country:US
Mailing Address - Phone:206-853-5020
Mailing Address - Fax:
Practice Address - Street 1:145 ALIDA ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2160
Practice Address - Country:US
Practice Address - Phone:206-853-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00003470103T00000X
OROB2818103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist