Individual provider Active NPI

Donna G. Dabney, PA

  • Medical Physician Assistant
  • Moses Lake, WA
National Provider Identifier
1851471361
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10004222 Issued in WA
Practice address
605 S Coolidge Street
Moses Lake, WA 98837
Phone
(509) 765-0674
Fax
(509) 764-0344
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 025211 PA10004222 WA
Medical Physician Assistant 363AM0700X PA10004222 WA Primary

Addresses

Primary practice location

605 S Coolidge Street
Moses Lake, WA 98837

Mailing address

605 S Coolidge St
Moses Lake, WA 98837-1893
Phone (509) 765-0674

Other identifiers 2

IdentifierTypeStateIssuer
P01403524OtherWARR MEDICARE
1851471361MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000966 WA Practitioner - Physician Assistant 9537054762 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025211 PA10004222WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wenatchee Valley Hospital CurrentSince Dec 2, 2013 Accepting new patients
Moses Lake Community Health Center CurrentSince Nov 17, 2003 Accepting new patients
Moses Lake Community Health Center CurrentSince Nov 17, 2003 Accepting new patients
Lewis County Hospital District No. 1 Current Accepting new patients

Locations

605 S Coolidge St
Moses Lake, WA 98837
Phone (509) 765-0674

605 S Coolidge St
#101
Moses Lake, WA 98837
Phone (509) 765-0674

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1851471361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-765-0674",
            "fax_number": "509-764-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE STREET",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "98837",
            "telephone_number": "509-765-0674",
            "fax_number": "509-764-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABNEY",
        "first_name": "DONNA",
        "middle_name": "G.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "025211 PA10004222",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01403524",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851471361",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.