Provider Demographics
NPI:1184150344
Name:RHEUMATOLOGY AND AUTOIMMUNE CENTER PLLC
Entity type:Organization
Organization Name:RHEUMATOLOGY AND AUTOIMMUNE CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIVIANE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BUNIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PHD,FACP
Authorized Official - Phone:206-582-8484
Mailing Address - Street 1:14100 SE 36TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1657
Mailing Address - Country:US
Mailing Address - Phone:206-502-8772
Mailing Address - Fax:425-698-1279
Practice Address - Street 1:14100 SE 36TH ST STE 105
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006
Practice Address - Country:US
Practice Address - Phone:206-502-8772
Practice Address - Fax:425-698-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60715269261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA=========OtherIRS