Provider Demographics
NPI:1972857100
Name:MARKS, DONETTE FAYE (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:DONETTE
Middle Name:FAYE
Last Name:MARKS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:MRS
Other - First Name:DONETTE
Other - Middle Name:FAYE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLPA
Mailing Address - Street 1:755 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:WA
Mailing Address - Zip Code:99323-8523
Mailing Address - Country:US
Mailing Address - Phone:509-547-2136
Mailing Address - Fax:509-546-0603
Practice Address - Street 1:755 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:WA
Practice Address - Zip Code:99323-8523
Practice Address - Country:US
Practice Address - Phone:509-547-2136
Practice Address - Fax:509-546-0603
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP602416722355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant