Basic Information
Provider Information
NPI: 1801073457
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DONAHOE
FirstName: KEVIN
MiddleName: JOHN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 203 N WASHINGTON ST STE 300
Address2:  
City: SPOKANE
State: WA
PostalCode: 992010233
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber: 5094447806
Practice Location
Address1: 15812 E INDIANA AVE
Address2:  
City: SPOKANE VALLEY
State: WA
PostalCode: 992161875
CountryCode: US
TelephoneNumber: 5094448200
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/25/2008
LastUpdateDate: 02/05/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XMD60258467WAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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