Provider Demographics
NPI:1679302210
Name:MCDONALD, ASHLYNN MICHELLE
Entity type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:MICHELLE
Last Name:MCDONALD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 GRANT AVE S APT I301
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-3091
Mailing Address - Country:US
Mailing Address - Phone:360-536-2060
Mailing Address - Fax:
Practice Address - Street 1:1411 GRANT AVE S APT I301
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-3091
Practice Address - Country:US
Practice Address - Phone:360-536-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61594473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health