Provider Demographics
NPI:1316235773
Name:BERUBE, DONNA L (RNFA)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:BERUBE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 42ND AVE E
Mailing Address - Street 2:#247
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-2571
Mailing Address - Country:US
Mailing Address - Phone:206-240-0398
Mailing Address - Fax:
Practice Address - Street 1:2510 42ND AVE E
Practice Address - Street 2:#247
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-2571
Practice Address - Country:US
Practice Address - Phone:206-240-0398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2012-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00156169163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant