Provider Demographics
NPI:1104801372
Name:ASHLEY, DONALD K (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:K
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:K
Other - Last Name:ASHLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1111 S 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4118
Mailing Address - Country:US
Mailing Address - Phone:509-522-0100
Mailing Address - Fax:509-527-8010
Practice Address - Street 1:1111 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4118
Practice Address - Country:US
Practice Address - Phone:509-522-0100
Practice Address - Fax:509-527-8010
Is Sole Proprietor?:No
Enumeration Date:2005-12-10
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030628208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE69375Medicare UPIN