GARY DALE MONTGOMERY (NPI# 1104299601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104299601 |
| Entity Type | Individual |
| Full Name | GARY DALE MONTGOMERY |
| Credential | PA-C |
| Practice Address |
12800 Bothell Everett Hwy Ste A Everett WA 98208-6642 |
| Mailing Address |
Po Box 827 Bellevue WA 98009-0827 |
| Practice Telephone | 4253165150 |
| Practice Fax Number | 4259033142 |
| Mailing Telephone | 4255636258 |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2017-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60577634 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518095546 | Gary Montgomery | Dentist | 21851 Center Ridge Road, Suite 205, Rocky River, OH 44116 | 2007-03-01 |
| 1710099189 | Gary P Montgomery | Counselor | 132 Trumbull St, Saint Clair, MI 48079-5372 | 2006-08-31 |
| 1255734356 | Gary Mark Montgomery | Obstetrics & Gynecology | 6100 Harris Pkwy, Fort Worth, TX 76132-4101 | 2014-10-02 |
| 1730196882 | Gary L Montgomery | Pediatrics | 1100 Lake Hearn Dr, Ste 450, Atlanta, GA 30342 | 2006-08-02 |
| Street Address |
12800 BOTHELL EVERETT HWY STE A |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-6642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518963404 | James Daniel Bass | Family Medicine | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2005-06-24 |
| 1437620499 | Laboratory Corporation of America | Clinical Medical Laboratory | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2018-12-16 |
| 1306375563 | Coreyanne L Griffin | Counselor | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2017-06-09 |
| 1407389448 | Bushra Rahman | Internal Medicine | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2017-04-06 |
| 1831639731 | Providence Health & Services | Home Health Aide | 12800 Bothell Everett Hwy, Suite 290, Everett, WA 98208-6642 | 2017-02-27 |
| 1700325826 | Caroline Judd | Social Worker | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2017-02-22 |
| 1225485550 | Amy Barrows | Nurse Practitioner | 12800 Bothell Everett Hwy, Suite 120, Everett, WA 98208-6642 | 2016-05-17 |
| 1457731556 | Laura Knapp | Counselor | 12800 Bothell Everett Hwy, Suite 290, Everett, WA 98208-6642 | 2015-06-03 |
| 1174903603 | Justin Gill | Nurse Practitioner | 12800 Bothell Everett Hwy, Everett, WA 98208 | 2015-05-29 |
| 1407271547 | Sayed Amirhossein Khademi | Internal Medicine | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2014-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912521956 | Juliana Martins | Physician Assistant | 31 Freeman Ave, Everett, MA 02149-5204 | 2020-06-05 |
| 1528606324 | Lynda Lee Consolo | Physician Assistant | 18 Woodlawn Ave, Everett, MA 02149-5417 | 2019-12-12 |
| 1538519202 | Kristen Shafer | Physician Assistant | 2038 Winding Ridge Rd, Everett, PA 15537-4274 | 2016-06-14 |
| 1588098909 | Lidia Yemchuk | Physician Assistant | 4201 Rucker Ave, Everett, WA 98203-2215 | 2013-08-22 |
| 1134426133 | Anthony Joseph Danna | Physician Assistant | 103 Garland St Emergency Department, Everett, MA 02149-5066 | 2011-02-28 |
| 1902058019 | Matthew James Slater | Physician Assistant | 1330 Rockefeller Ave Ste 400, Everett, WA 98201-1676 | 2008-10-21 |
| 1417133216 | Patricia Ann Buehler | Physician Assistant | 3726 Broadway Ste 101, Everett, WA 98201-3787 | 2008-01-11 |
| 1558404814 | Margarita G Burdetsky | Physician Assistant | 391 Broadway Ste 204, Prohealth Intagrated Medical, Everett, MA 02149-3471 | 2007-02-15 |
| 1427127158 | Marcy Jo Herzog | Physician Assistant | 185 Hospital Dr Ste 1, Everett, PA 15537-7018 | 2006-11-07 |
| 1376553966 | Erin M Richards | Physician Assistant | 249 Hospital Drive Suite 1, Everett, PA 15537 | 2006-08-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.