Provider Demographics
NPI:1225063100
Name:WILLIAMS, DONALD K (DO)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 N CHERRY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1152
Mailing Address - Country:US
Mailing Address - Phone:509-991-3054
Mailing Address - Fax:509-926-4669
Practice Address - Street 1:2310 N CHERRY ST STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1152
Practice Address - Country:US
Practice Address - Phone:509-991-3054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP-2052207Q00000X, 207Q00000X
IDO-340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807137200Medicaid
ID807137200Medicaid
WAG8858149Medicare PIN