Provider Demographics
NPI:1528014263
Name:MALONE, DONALD HAROLD (LMP)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:HAROLD
Last Name:MALONE
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4600 UNION BAY PL NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4037
Mailing Address - Country:US
Mailing Address - Phone:206-799-1402
Mailing Address - Fax:425-898-0728
Practice Address - Street 1:4600 UNION BAY PL NE
Practice Address - Street 2:SUITE B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4037
Practice Address - Country:US
Practice Address - Phone:206-799-1402
Practice Address - Fax:425-898-0728
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014497225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist