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General NPI Number Information
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NPI Number | 1093409872
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Entity Type | Individual
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Provider Name | DEJANELLE C BUNCH DPT
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Gender | Female
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 2929 5TH AVE NE
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City | PUYALLUP
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State | WA
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Zip | 98372-6782
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Country | US
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Telephone | 253-447-8216
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Fax |
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Provider Business Mailing Address
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Address Line | 12414 172ND ST E APT A101
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City | PUYALLUP
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State | WA
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Zip | 98374-9189
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Country | US
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Telephone | 360-320-2488
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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