Provider Demographics
NPI:1831843788
Name:DONE, GREGORY DAVID (MA, DSOM)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:DAVID
Last Name:DONE
Suffix:
Gender:M
Credentials:MA, DSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 SE 3RD ST APT 101
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-1378
Mailing Address - Country:US
Mailing Address - Phone:971-396-6147
Mailing Address - Fax:
Practice Address - Street 1:120 E BIRCH ST STE 2
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3054
Practice Address - Country:US
Practice Address - Phone:509-520-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61260989171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist