MEDICARE: BETH DONELAN PA-C

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	363A00000X	Physician Assistant	0308	SD

General Provider Information

NPI Number	:	1306923610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH DONELAN PA-C

Provider Business Mailing Address
First Line	:	6400 SOUTHCENTER BLVD
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-2547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10700 MERIDIAN AVE N STE G11
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-9008
Country	:	US
Telephone Number	:	206-461-4544
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	01/31/2022

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Directions to “ BETH DONELAN PA-C” Practice Location

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