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Individual

LUCAS PAUL DONALDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
8796 W TILLAMOOK DR, BOISE, ID 83709-5876
(208) 861-5609
Mailing address
8796 W TILLAMOOK DR, BOISE, ID 83709-5876
(208) 861-5609

Taxonomy

Speciality
Code
Description
License number
State
163WP1700X
Perinatal Registered Nurse
56025
ID
363LF0000X
Family Nurse Practitioner
Primary
56025
ID

Other

Enumeration date
03/23/2021
Last updated
04/30/2025
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