Individual
SHELLY DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2016 NE 65TH ST STE B, SEATTLE, WA 98115-6958
(206) 729-6211
Mailing address
4703 S ROSE ST, SEATTLE, WA 98118-4440
(206) 250-8347
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 00009834
WA
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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