Donna M Landry, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10002558 Issued in WA

Practice address

1603 Cooper Point Rd NW
Olympia, WA 98502-8325

Phone

(360) 753-0396

Fax

(360) 539-7937

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2876/brand/1/csg/201/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Capital Medical Center Physicians LLC

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1629214283
  Medicare reassignment
• South Sound Surgical Associates

  • Vascular Surgery Physician
  • Olympia, WA
  • NPI 1639261258
  Medicare reassignment
• Capital Medical Center Physicians LLC

  • Family Medicine Physician
  • Tumwater, WA
  • NPI 1568229540
  NPD
• Capital Medical Center Physicians LLC

  • Internal Medicine Physician
  • Montesano, WA
  • NPI 1710744792
  NPD
• South Sound Family & Sports

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1558446211
  NPD (past)
• South Sound Health & Fitness

  • Physical Therapy Clinic/Center
  • Olympia, WA
  • NPI 1396914628
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366523490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 COOPER POINT RD NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028325",
            "telephone_number": "360-753-0396",
            "fax_number": "360-539-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 COOPER POINT RD NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028325",
            "telephone_number": "360-753-0396",
            "fax_number": "360-539-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "DONNA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10002558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "5617199",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASH ST LICENSE",
            "identifier": "OA10000203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3568326",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "O198234",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "2007LA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BC",
            "identifier": "A1820",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Levi Lancaster, PHARM.D.
• Angela Land
• Gavin Landaker
• Kelsey Rose Landis, LMT
• Amber Landry
• Robin Adalina Landsong, L.M.P.
• Aaron Curtis Lane
• Angelique Monica Lane, SUDPT
• Carmen Lane
• Katheryn Lane

• Medical Physician Assistant in Olympia, WA
• Providers in Olympia, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.