Individual
GREGORY R MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N. CHELAN AVE., WENATCHEE, WA 98801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005244
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225224090
—
WA
01
—
G8920080
WVH PTAN
WA
01
—
G8920081
WVH PTAN
WA
Enumeration date
09/14/2007
Last updated
07/25/2022
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