Provider Demographics
NPI:1881937985
Name:BUNKER, ALLISON L (PT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:BUNKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:L
Other - Last Name:KAUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:12452 155TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-6307
Mailing Address - Country:US
Mailing Address - Phone:425-442-2934
Mailing Address - Fax:
Practice Address - Street 1:400 S 43RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055
Practice Address - Country:US
Practice Address - Phone:425-656-5165
Practice Address - Fax:425-656-4028
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60269508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2067738Medicaid