MEDICARE: MRS. LORI T MONTAIGUE MA, RD

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	133N00000X	Nutritionist	845372	CA
2	133NN1002X	Nutrition Education Nutritionist	845372	CA
3	133V00000X	Registered Dietitian	845372	CA

General Provider Information

NPI Number	:	1922000629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI T MONTAIGUE MA, RD

Provider Business Mailing Address
First Line	:	2415 W WALKER CT
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-5514
Country	:	US
Telephone Number	:	509-671-0032
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 W WALKER CT
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-5514
Country	:	US
Telephone Number	:	509-671-0032
Fax Number	:

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	02/07/2025

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