Provider Demographics
NPI:1770726002
Name:HUNZINGER, PETER JON (LMP)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:JON
Last Name:HUNZINGER
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17530 NE UNION HILL RD., STE 270
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3387
Mailing Address - Country:US
Mailing Address - Phone:425-558-1266
Mailing Address - Fax:425-650-2187
Practice Address - Street 1:17530 NE UNION HILL RD., STE 270
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3387
Practice Address - Country:US
Practice Address - Phone:425-558-1266
Practice Address - Fax:425-650-2187
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00024038225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist