Provider Demographics
NPI:1962116715
Name:DONACA, CORTNEY MAE
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:MAE
Last Name:DONACA
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 1:2620 NW 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-8201
Mailing Address - Country:US
Mailing Address - Phone:503-330-2475
Mailing Address - Fax:
Practice Address - Street 1:1827 NE 44TH AVE STE 390
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1461
Practice Address - Country:US
Practice Address - Phone:503-963-6494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No374J00000XNursing Service Related ProvidersDoula