Healthcare Provider Details

I. General information

NPI: 1710193891
Provider Name (Legal Business Name): PRIYA ALEXANDRA MONRAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 6TH AVE STE 100
TACOMA WA
98405-4048
US

IV. Provider business mailing address

1112 6TH AVE STE 100
TACOMA WA
98405-4048
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-9343
  • Fax: 253-272-2594
Mailing address:
  • Phone: 253-403-9343
  • Fax: 253-272-2594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301088438
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number51207
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number103725
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number55899
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: