Provider Demographics
NPI:1598902215
Name:HARWOOD, MONTE KYLE (PA)
Entity type:Individual
Prefix:
First Name:MONTE
Middle Name:KYLE
Last Name:HARWOOD
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 W 113TH ST APT 5116
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2486
Mailing Address - Country:US
Mailing Address - Phone:913-244-8462
Mailing Address - Fax:
Practice Address - Street 1:1111 3RD AVE STE 1100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3207
Practice Address - Country:US
Practice Address - Phone:913-244-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA1802363A00000X
KS15-02830363A00000X
WAPA60201520363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB158853Medicare PIN
TXTXB158852Medicare PIN
TXTXB158851Medicare PIN