Provider Demographics
NPI:1578703203
Name:DONALD, KAREN A
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:DONALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:DONALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:1721 TAYLOR AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2926
Mailing Address - Country:US
Mailing Address - Phone:206-283-4972
Mailing Address - Fax:
Practice Address - Street 1:1721 TAYLOR AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2926
Practice Address - Country:US
Practice Address - Phone:206-283-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00010717174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist