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NPI Code Detail

MEDICARE: LAUREL BUNKER NIC MASTER

MEDICARE:   LAUREL  BUNKER  NIC MASTER
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
1171R00000XInterpreter

General Provider Information

NPI Number : 1770895583
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREL BUNKER NIC MASTER
Provider Business Mailing Address
First Line : 27237 213TH PL SE
Second Line :
City : MAPLE VALLEY
State : WA
Zip : 98038-3352
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 27237 213TH PL SE
Second Line :
City : MAPLE VALLEY
State : WA
Zip : 98038-3352
Country : US
Telephone Number : 425-584-7318
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2010
Last Update Date : 07/09/2010

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Directions to “ LAUREL BUNKER NIC MASTER” Practice Location

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