Provider Demographics
NPI:1356486799
Name:SMITH, DONALEE
Entity Type:Individual
Prefix:
First Name:DONALEE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87860 TERRITORIAL RD
Mailing Address - Street 2:#73
Mailing Address - City:VENETA
Mailing Address - State:OR
Mailing Address - Zip Code:97487-9764
Mailing Address - Country:US
Mailing Address - Phone:541-228-6240
Mailing Address - Fax:
Practice Address - Street 1:1790 W 11TH AVE
Practice Address - Street 2:290
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3758
Practice Address - Country:US
Practice Address - Phone:541-686-1262
Practice Address - Fax:541-626-0359
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health