Provider Demographics
NPI:1134128697
Name:CONDON, DONALD F (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:F
Last Name:CONDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9631 N NEVADA ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1133
Mailing Address - Country:US
Mailing Address - Phone:509-467-1100
Mailing Address - Fax:509-468-0173
Practice Address - Street 1:9631 N NEVADA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1133
Practice Address - Country:US
Practice Address - Phone:509-467-1100
Practice Address - Fax:509-468-0173
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00016998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1005800Medicaid
WA1005800Medicaid
WAA07139Medicare UPIN