Provider Demographics
NPI:1689736498
Name:DUNBAR, PHILIP GORDON (RPH PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:GORDON
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:RPH PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13224 S CLEAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MEDICAL LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99022-9322
Mailing Address - Country:US
Mailing Address - Phone:509-299-1930
Mailing Address - Fax:509-299-1967
Practice Address - Street 1:S 2320 SALNAVE RD
Practice Address - Street 2:
Practice Address - City:MEDICAL LAKE
Practice Address - State:WA
Practice Address - Zip Code:99022
Practice Address - Country:US
Practice Address - Phone:509-299-1930
Practice Address - Fax:509-299-1967
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00010525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist