Provider Demographics
NPI:1386703254
Name:MONTIEL, MARCHAND MARIE (MPT)
Entity type:Individual
Prefix:MRS
First Name:MARCHAND
Middle Name:MARIE
Last Name:MONTIEL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:MARCHAND
Other - Middle Name:MARIE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:6177 RIVER CREST DR
Mailing Address - Street 2:STE A
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0728
Mailing Address - Country:US
Mailing Address - Phone:509-628-3516
Mailing Address - Fax:
Practice Address - Street 1:4215 CONVENTION PL
Practice Address - Street 2:SUITE B
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-8148
Practice Address - Country:US
Practice Address - Phone:509-545-1010
Practice Address - Fax:509-545-1112
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist