Provider Demographics
NPI:1851101489
Name:MONCADA, ELI JAIME
Entity type:Individual
Prefix:MR
First Name:ELI
Middle Name:JAIME
Last Name:MONCADA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 ARNOLD DR
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-3150
Mailing Address - Country:US
Mailing Address - Phone:509-989-2535
Mailing Address - Fax:
Practice Address - Street 1:1309 ARNOLD DR
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-3150
Practice Address - Country:US
Practice Address - Phone:509-989-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty