Provider Demographics
NPI:1144492117
Name:WEST, DONNA REA (LPN)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:REA
Last Name:WEST
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:REA
Other - Last Name:HURLBURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4619 NE 112TH AVE
Mailing Address - Street 2:APT V104
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-6688
Mailing Address - Country:US
Mailing Address - Phone:360-883-0553
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-30
Last Update Date:2008-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse