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General NPI Number Information
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NPI Number | 1235660424
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Entity Type | Individual
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Provider Name | TRENT DONDERO
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Gender | Male
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1660 S COLUMBIAN WAY
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City | SEATTLE
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State | WA
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Zip | 98108-1532
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Country | US
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Telephone | 206-762-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 V ST #1100
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City | SACRAMENTO
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State | CA
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Zip | 95817-1460
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Country | US
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Telephone | 916-734-2737
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD61152924
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License Number State | WA
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