MEDICARE: DR. JOHN E DUNNE 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	2084P0804X	Child & Adolescent Psychiatry Physician	MD00014418	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DU2898	OTHER	WA	REGENCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619283124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E DUNNE MD

Provider Business Mailing Address
First Line	:	16040 CHRISTENSEN RD STE 217
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-2966
Country	:	US
Telephone Number	:	206-243-7383
Fax Number	:	206-241-7346

Provider Business Practice Location Address
First Line	:	16040 CHRISTENSEN RD STE 217
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-2966
Country	:	US
Telephone Number	:	206-243-7383
Fax Number	:	206-241-7346

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

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	08/20/2010

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