Provider Demographics
NPI:1689887929
Name:HUNTER, DANA BRAD (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:BRAD
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11990 SW CORBY DR
Mailing Address - Street 2:#10
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5915
Mailing Address - Country:US
Mailing Address - Phone:413-977-1420
Mailing Address - Fax:
Practice Address - Street 1:888 SWIFT BLVD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3514
Practice Address - Country:US
Practice Address - Phone:509-946-4611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13670207P00000X
ORMD28973207P00000X
AK6316207P00000X
WAMD601082274207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHAA106135OtherHARVARD PILGRIM
WA207P00000XMedicaid
NH30207214Medicaid
NH01Y012631NH01OtherBCBS
NHP00442996OtherRAILROAD MEDICARE
H68001Medicare UPIN
NHAA106135OtherHARVARD PILGRIM