Provider Demographics
NPI:1891420634
Name:HOANG-MONCINO, VICKY
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:HOANG-MONCINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3290 NE 65TH ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7200
Mailing Address - Country:US
Mailing Address - Phone:206-388-2549
Mailing Address - Fax:
Practice Address - Street 1:3290 NE 65TH ST UNIT 101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7200
Practice Address - Country:US
Practice Address - Phone:206-388-2549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-17
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61324137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist