Provider Demographics
NPI:1134338551
Name:DONNEL, VICKY LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:VICKY
Middle Name:LYNN
Last Name:DONNEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14050 JUANITA DR N.E.
Mailing Address - Street 2:SUITE B
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-821-3775
Mailing Address - Fax:425-821-1986
Practice Address - Street 1:14050 JUANITA DR N.E.
Practice Address - Street 2:SUITE B
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-821-3775
Practice Address - Fax:425-821-1986
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist