Provider Demographics
NPI:1336225184
Name:DUNN, CHRISTOPHER WILLIAMS
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WILLIAMS
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:ID
Mailing Address - Zip Code:83313-0401
Mailing Address - Country:US
Mailing Address - Phone:206-251-4890
Mailing Address - Fax:
Practice Address - Street 1:DUNN PSYCHOLOGICAL SERVICES
Practice Address - Street 2:191 SUN VALLEY RD
Practice Address - City:KETCHUM
Practice Address - State:ID
Practice Address - Zip Code:83340
Practice Address - Country:US
Practice Address - Phone:206-251-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001844103TC0700X
IDPSY-203448103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8352437Medicaid
WA620005856OtherRAIL ROAD MEDICARE
191730OtherINTERNAL ID-MOTOR VEHICLE ID
WAAB16242Medicare PIN
S77181Medicare UPIN