Provider Demographics
NPI:1902124233
Name:DONAHUE, KELLY C (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:C
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 MARLIN DR E
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1406
Mailing Address - Country:US
Mailing Address - Phone:412-849-6611
Mailing Address - Fax:
Practice Address - Street 1:2010 CATON WAY SW STE 102
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8201
Practice Address - Country:US
Practice Address - Phone:412-200-5611
Practice Address - Fax:844-813-3892
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
WAGT60730580170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS