Provider Demographics
NPI:1952584120
Name:MCELDERRY, DONALD RAYMOND (BA, MA (INTERN))
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RAYMOND
Last Name:MCELDERRY
Suffix:
Gender:M
Credentials:BA, MA (INTERN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18943 COOK RD SE
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-9656
Mailing Address - Country:US
Mailing Address - Phone:360-400-2947
Mailing Address - Fax:
Practice Address - Street 1:514 S 13TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1908
Practice Address - Country:US
Practice Address - Phone:253-396-5000
Practice Address - Fax:253-383-5548
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health