Provider Demographics
NPI:1962509307
Name:HERMAN-DUNN, RUTH A (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:A
Last Name:HERMAN-DUNN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 42ND AVE SW
Mailing Address - Street 2:STE 540
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4561
Mailing Address - Country:US
Mailing Address - Phone:206-937-1186
Mailing Address - Fax:
Practice Address - Street 1:4700 42ND AVE SW
Practice Address - Street 2:STE 540
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4561
Practice Address - Country:US
Practice Address - Phone:206-937-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY1852103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA217000435Medicare ID - Type Unspecified