Individual
DONNA C. QUEYQUEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2320 FREEWAY DRIVE, MOUNT VERNON, WA 98273
(802) 527-8189
(802) 527-8187
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
12152
NV
208000000X
Pediatrics Physician
Primary
MD60106936
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2005521
—
WA
01
—
263819
LABOR & INDUSTRIES
WA
Enumeration date
02/07/2007
Last updated
06/23/2015
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