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Individual

MS. DONNA M LANDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
1603 COOPER POINT RD NW, OLYMPIA, WA 98502-8325
(360) 753-0396
(360) 539-7937
Mailing address
1603 COOPER POINT RD NW, OLYMPIA, WA 98502-8325
(360) 753-0396
(360) 539-7937

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10002558
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2007LA
REGENCE
01
3568326
AETNA HMO
01
5617199
AETNA NON HMO
01
A1820
PREMERA BC
01
O198234
LABOR & INDUSTRIES
01
OA10000203
WASH ST LICENSE
Enumeration date
10/17/2006
Last updated
03/07/2023
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