Healthcare Provider Details

I. General information

NPI: 1588638787
Provider Name (Legal Business Name): RICHARD JOHN MONTMINY M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 196TH ST SW STE D US HEALTHWORKS MEDICAL GROUP
LYNNWOOD WA
98036-6753
US

IV. Provider business mailing address

4320 196TH ST SW STE B PMB# 304
LYNNWOOD WA
98036-6754
US

V. Phone/Fax

Practice location:
  • Phone: 425-774-8758
  • Fax: 425-672-8944
Mailing address:
  • Phone: 425-774-8758
  • Fax: 425-672-8944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberME56307
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberMD20090722
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD20090722
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberMD60394447
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberMD60394447
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD60394447
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: