Healthcare Provider Details

I. General information

NPI: 1053830182
Provider Name (Legal Business Name): NATALIE MONCAYO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2017
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15809 BEAR CREEK PKWY STE 100
REDMOND WA
98052-1542
US

IV. Provider business mailing address

15809 BEAR CREEK PKWY STE 100
REDMOND WA
98052-1542
US

V. Phone/Fax

Practice location:
  • Phone: 425-882-6100
  • Fax: 425-882-7690
Mailing address:
  • Phone: 425-882-6100
  • Fax: 425-882-7690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number32860
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: