MEDICARE: DR. JEFFREY WILLIAM DONESKEY D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DE00009173	WA

General Provider Information

NPI Number	:	1932238342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY WILLIAM DONESKEY D.M.D.

Provider Business Mailing Address
First Line	:	2335 127TH AVE NE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-1563
Country	:	US
Telephone Number	:	425-869-1143
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 116TH AVE NE
Second Line	:	SUITE C
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3802
Country	:	US
Telephone Number	:	425-646-6409
Fax Number	:	425-671-1119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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