Provider Demographics
NPI:1417101676
Name:DUNAWAY, DEBORAH LAMDEN (PA-C)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LAMDEN
Last Name:DUNAWAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11610 N 17TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-1320
Mailing Address - Country:US
Mailing Address - Phone:480-818-8153
Mailing Address - Fax:
Practice Address - Street 1:5090 N 40TH ST STE 122
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2112
Practice Address - Country:US
Practice Address - Phone:602-264-5685
Practice Address - Fax:602-631-9870
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4344363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant