Provider Demographics
NPI:1780704023
Name:DUNNAM, ROMINA CATHY (DO)
Entity type:Individual
Prefix:
First Name:ROMINA
Middle Name:CATHY
Last Name:DUNNAM
Suffix:
Gender:F
Credentials:DO
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 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:800-994-0371
Mailing Address - Fax:254-215-9722
Practice Address - Street 1:5350 TALLMAN AVE NW STE 420
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5902
Practice Address - Country:US
Practice Address - Phone:206-781-6161
Practice Address - Fax:206-781-6285
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60151339207V00000X
TXU0475207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1780704023Medicaid