MEDICARE: BRIAN LYNN DUNKLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	MD16108	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497702062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN LYNN DUNKLEY MD

Provider Business Mailing Address
First Line	:	KAISER SUNNYSIDE MEDICAL OFFICE
Second Line	:	10180 SE SUNNYSIDE RD
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-9764
Country	:	US
Telephone Number	:	503-813-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	KAISER SUNNYSIDE MEDICAL OFFICE
Second Line	:	10180 SE SUNNYSIDE RD
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-9764
Country	:	US
Telephone Number	:	503-813-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	07/10/2007

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