Provider Demographics
NPI:1508293895
Name:MCDONALD, ASHLEY LYN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LYN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:LYN
Other - Last Name:SCHOLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:11470 BUSINESS BLVD
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7780
Mailing Address - Country:US
Mailing Address - Phone:907-696-5678
Mailing Address - Fax:907-696-2248
Practice Address - Street 1:11470 BUSINESS BLVD
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7780
Practice Address - Country:US
Practice Address - Phone:907-696-5678
Practice Address - Fax:907-696-2248
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHY L 220225100000X
IDPT-3230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist