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Individual

DONNA LOUISE ELAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3118 BANKS LN SW, TUMWATER, WA 98512-1451
(360) 561-3098
Mailing address
3118 BANKS LN SW, TUMWATER, WA 98512-1451
(360) 561-3098

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52690
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8361933
WA
Enumeration date
01/17/2007
Last updated
03/12/2022
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