Provider Demographics
NPI:1619925591
Name:ARCHER, DONNA MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIA
Last Name:ARCHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:MARIA
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9330 NE VANCOUVER MALL DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-8204
Mailing Address - Country:US
Mailing Address - Phone:360-885-4715
Mailing Address - Fax:360-859-3741
Practice Address - Street 1:9330 NE VANCOUVER MALL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-8204
Practice Address - Country:US
Practice Address - Phone:360-885-4715
Practice Address - Fax:360-859-3941
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00147747OtherDEPT. OF LABOR & IND., WA
WAAB22661Medicare ID - Type UnspecifiedMEDICARE NUMBER