Provider Demographics
NPI:1679883854
Name:DUNN, AMBER GATTI (OD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:GATTI
Last Name:DUNN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15405 SW 116TH AVE
Mailing Address - Street 2:UNIT 204
Mailing Address - City:KING CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97224
Mailing Address - Country:US
Mailing Address - Phone:971-371-3927
Mailing Address - Fax:
Practice Address - Street 1:15405 SW 116TH AVE
Practice Address - Street 2:UNIT 204
Practice Address - City:KING CITY
Practice Address - State:OR
Practice Address - Zip Code:97224-2600
Practice Address - Country:US
Practice Address - Phone:971-371-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3510ATI152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program