Provider Demographics
NPI:1114259785
Name:DONALDSON, CATHRON (PT)
Entity Type:Individual
Prefix:
First Name:CATHRON
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 E BOTTLEBRUSH DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-7621
Mailing Address - Country:US
Mailing Address - Phone:928-514-6397
Mailing Address - Fax:
Practice Address - Street 1:912 RIORDAN RD.
Practice Address - Street 2:NAU INSTITUTE FOR HUMAN DEVELOPMENT
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86011-5630
Practice Address - Country:US
Practice Address - Phone:928-523-1695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ133422251P0200X
NC8930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist