Provider Demographics
NPI:1417159849
Name:CLELAND, DON W (DNP, CNP)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:W
Last Name:CLELAND
Suffix:
Gender:M
Credentials:DNP, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 E EVERGREEN BLVD
Mailing Address - Street 2:PMB 3033
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-4323
Mailing Address - Country:US
Mailing Address - Phone:458-250-4964
Mailing Address - Fax:458-250-6817
Practice Address - Street 1:2804 GRAND AVE STE 300D
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3586
Practice Address - Country:US
Practice Address - Phone:458-250-4964
Practice Address - Fax:458-250-6817
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2025-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202100768NPPP363LF0000X, 363LP0808X
WAAP61186015363LP0808X
CA218162278G1100X
CA22100363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500855263Medicaid