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General NPI Number Information
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NPI Number | 1477812873
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Entity Type | Individual
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Provider Name | ALFONSO RICARDO URDANETA-MONCADA MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 19020 33RD AVE W STE 210
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City | LYNNWOOD
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State | WA
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Zip | 98036-4748
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Country | US
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Telephone | 425-563-1500
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Fax | 425-563-1501
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Provider Business Mailing Address
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Address Line | 19020 33RD AVE W STE 210
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City | LYNNWOOD
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State | WA
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Zip | 98036-4748
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Country | US
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Telephone | 425-563-1500
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Fax | 425-563-1501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 116005
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | MD60665935
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | M-13632
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 116005
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License Number State | AK
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M-13632
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301501630
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD60665935
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License Number State | WA
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