Provider Demographics
NPI:1427770312
Name:OSBORNE, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 W JOHN DAY AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2456
Mailing Address - Country:US
Mailing Address - Phone:509-222-5600
Mailing Address - Fax:509-222-5601
Practice Address - Street 1:1701 N YOUNG ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1199
Practice Address - Country:US
Practice Address - Phone:509-528-1737
Practice Address - Fax:509-222-6101
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00117293163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00117293OtherWASHINGTON DOH