MEDICARE: DR S MCDONALD PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1912841446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR S MCDONALD PLLC

Provider Business Mailing Address
First Line	:	625 B ST
Second Line	:
City	:	CHENEY
State	:	WA
Zip	:	99004-1768
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 B ST
Second Line	:
City	:	CHENEY
State	:	WA
Zip	:	99004-1768
Country	:	US
Telephone Number	:	509-960-6020
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STACY MCDONALD
Credential	:
Telephone Number	:	509-960-6020

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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