Provider Demographics
NPI:1104958149
Name:DONAHUE, ROSE JENKINS (LMT)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:JENKINS
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-7717
Mailing Address - Country:US
Mailing Address - Phone:541-386-5135
Mailing Address - Fax:
Practice Address - Street 1:1190 SUNSET RD
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-7717
Practice Address - Country:US
Practice Address - Phone:541-386-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3450225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist