Provider Demographics
NPI:1841253408
Name:ZUNINO, BUD W (ARNP)
Entity type:Individual
Prefix:
First Name:BUD
Middle Name:W
Last Name:ZUNINO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-1809
Mailing Address - Country:US
Mailing Address - Phone:360-357-8822
Mailing Address - Fax:541-523-2399
Practice Address - Street 1:3175 POCAHONTAS RD
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-1434
Practice Address - Country:US
Practice Address - Phone:541-523-4415
Practice Address - Fax:541-523-2399
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005998363L00000X
OR200750136NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5452ZUOtherREGENCE
WAA006OtherTRICARE
WA9635343Medicaid