MEDICARE: DR. KRISTEN MARIE MONTAGUE PSYD, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LF60233333	WA

General Provider Information

NPI Number	:	1407039506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN MARIE MONTAGUE PSYD, LMFT

Provider Business Mailing Address
First Line	:	4701 SW ADMIRAL WAY # 87
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-2340
Country	:	US
Telephone Number	:	574-440-2272
Fax Number	:

Provider Business Practice Location Address
First Line	:	3429 FREMONT PL N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8660
Country	:	US
Telephone Number	:	574-440-2272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	05/03/2023

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