Provider Demographics
NPI:1982031621
Name:TUNISON, DANIELLE MARIE (RDA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:TUNISON
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 NE BOTHELL WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-9400
Mailing Address - Country:US
Mailing Address - Phone:425-806-8816
Mailing Address - Fax:425-806-8832
Practice Address - Street 1:5701 NE BOTHELL WAY STE 2
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-9400
Practice Address - Country:US
Practice Address - Phone:425-806-8816
Practice Address - Fax:425-806-8832
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602-478-998174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator