Provider Demographics
NPI:1720153513
Name:LAUNEY, DONNA S (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:S
Last Name:LAUNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 NE 87TH AVENUE
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664
Mailing Address - Country:US
Mailing Address - Phone:360-254-4914
Mailing Address - Fax:360-254-8988
Practice Address - Street 1:505 NE 87TH AVENUE
Practice Address - Street 2:SUITE LL50
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664
Practice Address - Country:US
Practice Address - Phone:360-254-4914
Practice Address - Fax:360-254-8988
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD181022085R0202X
WAMD000382002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR128954Medicaid
WA8135694Medicaid
WA8135694Medicaid
OR120909Medicare ID - Type Unspecified