Provider Demographics
NPI:1679800973
Name:SMITH, DONNA L (PA-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 59028
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-2028
Mailing Address - Country:US
Mailing Address - Phone:425-251-5110
Mailing Address - Fax:425-793-7458
Practice Address - Street 1:400 S 43RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5714
Practice Address - Country:US
Practice Address - Phone:425-251-5110
Practice Address - Fax:425-793-4707
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2010-10-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant