Provider Demographics
NPI:1619283124
Name:DUNNE, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:DUNNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16040 CHRISTENSEN RD STE 217
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2966
Mailing Address - Country:US
Mailing Address - Phone:206-243-7383
Mailing Address - Fax:206-241-7346
Practice Address - Street 1:16040 CHRISTENSEN RD STE 217
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2966
Practice Address - Country:US
Practice Address - Phone:206-243-7383
Practice Address - Fax:206-241-7346
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000144182084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADU2898OtherREGENCE
WA1228600Medicaid
WA000171602Medicare PIN
WA1228600Medicaid