Provider Demographics
NPI:1154409639
Name:MCDONALD, KAYLEE R (ND)
Entity type:Individual
Prefix:DR
First Name:KAYLEE
Middle Name:R
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-1530
Mailing Address - Country:US
Mailing Address - Phone:360-829-1838
Mailing Address - Fax:360-829-1836
Practice Address - Street 1:700 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321
Practice Address - Country:US
Practice Address - Phone:360-829-1838
Practice Address - Fax:360-829-1836
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000781175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath