FREDERICK A MONTGOMERY MD INC PS (NPI# 1457410961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457410961 |
| Entity Type | Organization |
| Organization Name | FREDERICK A MONTGOMERY MD INC PS |
| Practice Address |
215 So 11th # D Yakima WA 98902 |
| Practice Telephone | 5092486192 |
| Practice Fax Number | 5094525433 |
| Mailing Telephone | 5092486192 |
| Mailing Fax Number | 5094525433 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. FREDERICK A MONTGOMERY (PRESIDENT) |
| Authorized Official Telephone | 5092486192 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
MD00009512 | WA | Allopathic & Osteopathic Physicians |
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD00009512 | WA | Allopathic & Osteopathic Physicians |
| X | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD00009512 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1591403 | 05 |
| Street Address |
215 SO 11TH # D |
| City | YAKIMA |
| State | WA |
| Zip Code | 98902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653203 | Laboratory Corporation of America | Clinical Medical Laboratory | 314 S 11th Ave Suite A, Yakima, WA 98902 | 2019-08-05 |
| 1669967865 | Rebecca Schrader | Speech-Language Pathologist | Children's Village 3801 Kern Road, Yakima, WA 98902 | 2018-06-29 |
| 1720572928 | Hyperbaric Centers of Washington | Preventive Medicine | 302 S. 12th Ave., Yakima, WA 98902 | 2018-06-20 |
| 1487155503 | Courtney Lombardi | Nurse Practitioner | 1515 W Yakima Ave, Yakima, WA 98902 | 2018-02-23 |
| 1003329665 | Maria-elena Mendoza | Case Manager/Care Coordinator | 918 E Mead Avenue, Yakima, WA 98902 | 2017-11-06 |
| 1679017610 | Claudia Zepeda | Massage Therapist | 3908 Creekside Loop Ste # 110, Yakima, WA 98902 | 2016-12-09 |
| 1093194425 | Silas Klaver | Podiatrist | 1607 Creekside Loop Ste 140, Yakima, WA 98902 | 2015-05-18 |
| 1821490905 | Jen Lynn Silver | Massage Therapist | 3512 Tieton Dr, Yakima, WA 98902 | 2014-09-20 |
| 1194131383 | Brenna Claire Hayes | Genetic Counselor, MS | 2903 W Walnut, Yakima, WA 98902 | 2014-07-08 |
| 1720400435 | Agnes Nadine Jeske | Speech-Language Pathologist | 621 S. 13th Ave., Mckinley Elementary School, Yakima, WA 98902 | 2014-01-15 |
| Find all providers in zip 98902 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487863999 | Phyllis Jo Henderson | Psychiatry & Neurology | 418 S 44th Ave, Yakima, WA 98908-3303 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811155773 | Raghuram B Bhat | Psychiatry & Neurology | 417 Ne 2nd Ave Ste 205, Camas, WA 98607 | 2008-05-28 |
| 1205956265 | Kevin Richard Wandler | Psychiatry & Neurology | 888 S Hillhurst Rd, Ridgefield, WA 98642-9063 | 2007-03-30 |
| 1962575951 | Marc D Pellicciaro | Psychiatry & Neurology | 12729 Northup Way Ste 6, Bellevue, WA 98005-1935 | 2006-11-16 |
| 1821188764 | Steven M Juergens | Psychiatry & Neurology | 11201 Se 8th St Ste 105, Bellevue, WA 98004-6420 | 2006-10-13 |
| 1225666951 | Radiant Path Psychiatry Pllc | Psychiatry & Neurology | 330 King St Ste 5, Wenatchee, WA 98801-2857 | 2020-03-30 |
| 1184101073 | Luke Rosen, Do, Pllc | Psychiatry & Neurology | 2501 Ne 134th St Ste 203, Vancouver, WA 98686-3026 | 2018-07-24 |
| 1386883726 | Seema Basnett | Psychiatry & Neurology | 10001 17th Pl S, Lower Level, Seattle, WA 98168-1615 | 2009-02-09 |
| 1093921660 | Allison Evans Gullo | Psychiatry & Neurology | 6926 Ne Fourth Plain Blvd, Vancouver, WA 98661-7369 | 2007-05-14 |
| 1497880355 | John R Moran | Psychiatry & Neurology | 12101 Ambaum Blvd Sw, Burien, WA 98146-2651 | 2007-02-22 |
| 1124120761 | Shamim Hashemi Nejad | Psychiatry & Neurology | 1221 Madison St, Seattle, WA 98104-3588 | 2006-09-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.