Provider Demographics
NPI:1689399792
Name:WAAL, DONNA (RPH)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:WAAL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SQUIRREL HILL LN
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1525
Mailing Address - Country:US
Mailing Address - Phone:781-789-6989
Mailing Address - Fax:
Practice Address - Street 1:207 ROCKLAND ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2222
Practice Address - Country:US
Practice Address - Phone:781-826-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist