Provider Demographics
NPI:1205225653
Name:STRUTHERS, DONALD
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:STRUTHERS
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 1:1674 FOXGLOVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8569
Mailing Address - Country:US
Mailing Address - Phone:866-280-7373
Mailing Address - Fax:
Practice Address - Street 1:1674 FOXGLOVE AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-8569
Practice Address - Country:US
Practice Address - Phone:866-280-7373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC10082480376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide