Provider Demographics
NPI:1679626808
Name:HALCROW, DONALD ALEXANDER (DC, PA-C)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ALEXANDER
Last Name:HALCROW
Suffix:
Gender:M
Credentials:DC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-0112
Mailing Address - Country:US
Mailing Address - Phone:509-464-6208
Mailing Address - Fax:888-316-1928
Practice Address - Street 1:2607 S SOUTHEAST BLVD BLDG A
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223
Practice Address - Country:US
Practice Address - Phone:509-464-6208
Practice Address - Fax:888-316-1928
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60930143363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR106652Medicare ID - Type Unspecified