Provider Demographics
NPI:1134129935
Name:NUNES, NATALIE L (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:L
Last Name:NUNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4238
Mailing Address - Country:US
Mailing Address - Phone:253-403-2900
Mailing Address - Fax:253-403-2915
Practice Address - Street 1:521 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4238
Practice Address - Country:US
Practice Address - Phone:253-403-2900
Practice Address - Fax:253-403-2915
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035250207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH56735Medicare UPIN