Provider Demographics
NPI:1528325545
Name:BAJELIS, DONNA FRANCES (PT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:FRANCES
Last Name:BAJELIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 ROSS RD
Mailing Address - Street 2:
Mailing Address - City:TWISP
Mailing Address - State:WA
Mailing Address - Zip Code:98856-9607
Mailing Address - Country:US
Mailing Address - Phone:206-713-9758
Mailing Address - Fax:206-275-0458
Practice Address - Street 1:103 ROSS RD
Practice Address - Street 2:
Practice Address - City:TWISP
Practice Address - State:WA
Practice Address - Zip Code:98856-9607
Practice Address - Country:US
Practice Address - Phone:206-713-9758
Practice Address - Fax:206-275-0458
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-15
Last Update Date:2012-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1495225100000X
MA45391225100000X
CT002152225100000X
CA9338225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist