Provider Demographics
NPI:1760423958
Name:HUNTER, GARY P (DO)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:P
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34612 6TH AVE S STE 300
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8723
Mailing Address - Country:US
Mailing Address - Phone:253-838-8552
Mailing Address - Fax:253-874-6089
Practice Address - Street 1:34612 6TH AVE S STE 300
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8723
Practice Address - Country:US
Practice Address - Phone:253-838-8552
Practice Address - Fax:253-874-6089
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001075207X00000X, 204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1010057Medicaid
WA219678OtherSTATE L&I
WA1010057Medicaid
WA219678OtherSTATE L&I
WAE20229Medicare UPIN