Provider Demographics
NPI:1407178080
Name:DONNA MARIA ARCHER, DC, LLC
Entity Type:Organization
Organization Name:DONNA MARIA ARCHER, DC, LLC
Other - Org Name:ARCHER FAMILY WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-885-4715
Mailing Address - Street 1:5512 NE 109TH CT.
Mailing Address - Street 2:SUITE A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6175
Mailing Address - Country:US
Mailing Address - Phone:360-885-4715
Mailing Address - Fax:360-859-3741
Practice Address - Street 1:5512 NE 109TH CT
Practice Address - Street 2:SUITE A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6175
Practice Address - Country:US
Practice Address - Phone:360-885-4715
Practice Address - Fax:360-859-3741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033998111N00000X
WAMA60133357225700000X
WAMA60127460225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty