Provider Demographics
NPI:1497844344
Name:DONLEY, KRISTI ROSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:ROSE
Last Name:DONLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 12TH AVE NW STE A1A
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8994
Mailing Address - Country:US
Mailing Address - Phone:425-391-0700
Mailing Address - Fax:425-391-3332
Practice Address - Street 1:1105 12TH AVE NW STE A1A
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8994
Practice Address - Country:US
Practice Address - Phone:425-391-0700
Practice Address - Fax:425-391-3332
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000100211223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics