Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD00009145 | WA |
NPI | 1134343676 |
---|---|
Provider Name | Michael Donlan |
First Address | Spokane, WA 99208-6717 |
Second Address | Spokane, WA 99208-6717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 08/07/2007 |