Provider Demographics
NPI:1265467914
Name:DEAN FUNABIKI AND ASSOCIATES , P.S.
Entity type:Organization
Organization Name:DEAN FUNABIKI AND ASSOCIATES , P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNABIKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:509-338-0848
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-0214
Mailing Address - Country:US
Mailing Address - Phone:509-338-0848
Mailing Address - Fax:509-334-3115
Practice Address - Street 1:1205 SE PROFESSIONAL MALL BLVD
Practice Address - Street 2:SUITE 113
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5423
Practice Address - Country:US
Practice Address - Phone:509-334-0677
Practice Address - Fax:509-334-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA319207200Medicare ID - Type UnspecifiedGROUP NUMBER