Provider Demographics
NPI:1184704058
Name:DONALDSON, DAVID W (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6444 E HAMPDEN AVE
Mailing Address - Street 2:STE D
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7673
Mailing Address - Country:US
Mailing Address - Phone:303-643-8633
Mailing Address - Fax:303-526-1669
Practice Address - Street 1:24000 US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9318
Practice Address - Country:US
Practice Address - Phone:303-643-8633
Practice Address - Fax:303-526-1669
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO8242-6Medicare ID - Type Unspecified