Individual
DR. DONALD LOREN SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 424-4111
Mailing address
505 S. 336TH ST., SUITE 600, FEDERAL WAY, WA 98003
(253) 838-6180
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00032809
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311628
LABOR & INDUSTRIES
WA
Enumeration date
07/03/2006
Last updated
03/02/2017
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