=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730311531
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DONALD K WILLIAMS DO PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2009
-----------------------------------------------------
Last Update Date | 06/22/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2310 N. CHERRY ST. SUITE 200
-----------------------------------------------------
City | SPOKANE VALLEY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-991-3054
-----------------------------------------------------
Fax | 509-926-4669
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2310 N. CHERRY ST. SUITE 200
-----------------------------------------------------
City | SPOKANE VALLEY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-991-3054
-----------------------------------------------------
Fax | 509-926-4669
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. DONALD K WILLIAMS
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 208-660-9394
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | O-340
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------