Provider Demographics
NPI:1922216472
Name:MACDONALD HEALTH CARE LLC
Entity Type:Organization
Organization Name:MACDONALD HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:509-628-3840
Mailing Address - Street 1:1950 KEENE RD BLDG J
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7752
Mailing Address - Country:US
Mailing Address - Phone:509-628-3840
Mailing Address - Fax:509-628-3860
Practice Address - Street 1:1360 N LOUISIANA ST # A737
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7171
Practice Address - Country:US
Practice Address - Phone:509-628-3840
Practice Address - Fax:509-628-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8857216Medicare ID - Type Unspecified
WAP96088Medicare UPIN