Provider Demographics
NPI:1821548579
Name:DONATH, IVY
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:
Last Name:DONATH
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:PO BOX 791
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:MT
Mailing Address - Zip Code:59632-0791
Mailing Address - Country:US
Mailing Address - Phone:406-830-1332
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 791
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:MT
Practice Address - Zip Code:59632-0791
Practice Address - Country:US
Practice Address - Phone:406-830-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No1744R1102XOther Service ProvidersSpecialistResearch Study
No385H00000XRespite Care FacilityRespite Care
No374U00000XNursing Service Related ProvidersHome Health Aide
No1744G0900XOther Service ProvidersSpecialistGraphics DesignerGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No347C00000XTransportation ServicesPrivate Vehicle
No376K00000XNursing Service Related ProvidersNurse's Aide