Organization Name: | FREDERICK A MONTGOMERY MD INC PS |
NPI Number: | 1457410961 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FREDERICK A MONTGOMERY (PRESIDENT) |
Mailing Address: | 215 So 11th # D Yakima |
State: | WA US |
Postal Code: | 98902 |
Phone Number: | 5092486192 |
Fax Number: | 5094525433 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | MD00009512 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |