Individual
DONNA L BENEDICKTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
210 E EVERGREEN BLVD, VANCOUVER, WA 98660
(360) 693-3693
(360) 693-6894
Mailing address
210 E EVERGREEN BLVD, VANCOUVER, WA 98660
(360) 693-3693
(360) 693-6894
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00004696
WA
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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