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General NPI Number Information
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NPI Number | 1336876747
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Entity Type | Organization
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Legal Business Name | DONNA ELAM PLLC
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 3118 BANKS LN SW
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City | TUMWATER
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State | WA
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Zip | 98512-1451
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Country | US
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Telephone | 313-719-1877
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Fax | 213-603-4337
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Provider Business Mailing Address
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Address Line | 3118 BANKS LN SW
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City | TUMWATER
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State | WA
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Zip | 98512-1451
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Country | US
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Telephone | 313-719-1877
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Fax | 213-603-4337
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Authorized Official
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Title or Position | PSYCHIATRIC PHYSICIAN ASSOCIATE
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Name | DONNA LOUISE ELAM
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Credential | PA-C
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Telephone | 313-719-1877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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