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General NPI Number Information
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NPI Number | 1760163992
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Entity Type | Individual
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Provider Name | THERESIA DONOVAN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 1901 S CEDAR ST STE 301
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City | TACOMA
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State | WA
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Zip | 98405-2302
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Country | US
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Telephone | 253-572-7320
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 S CEDAR ST STE 301
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City | TACOMA
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State | WA
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Zip | 98405-2302
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP.AP.70149297-NP
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60662098
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License Number State | WA
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