Provider Demographics
NPI:1639227820
Name:MATNEY, DONNA ROSE (OD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:ROSE
Last Name:MATNEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16690 SE 56TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5530
Mailing Address - Country:US
Mailing Address - Phone:425-644-5644
Mailing Address - Fax:
Practice Address - Street 1:15617 BEL RED RD
Practice Address - Street 2:SUITE A
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2347
Practice Address - Country:US
Practice Address - Phone:425-558-9082
Practice Address - Fax:425-558-9089
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA 3182 TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist