Individual
DR. WALLACE ALVIN DONALDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 6TH ST, ZILLAH, WA 98953-9442
(509) 829-5699
(509) 829-6366
Mailing address
102 6TH ST, ZILLAH, WA 98953-9442
(509) 829-5699
(509) 829-6366
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00009019
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1531508
—
WA
Enumeration date
02/14/2006
Last updated
01/03/2012
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