Provider Demographics
NPI:1689387086
Name:GUNTER, PETER
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:GUNTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19808 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4131
Mailing Address - Country:US
Mailing Address - Phone:206-779-5917
Mailing Address - Fax:425-226-1759
Practice Address - Street 1:1901 SHATTUCK AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4249
Practice Address - Country:US
Practice Address - Phone:206-779-5917
Practice Address - Fax:425-226-1759
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA752320310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility