Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301099047 | MI |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD60636781 | WA |
NPI | 1629363734 |
---|---|
Provider Name | Dr. Lea Gunnell |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 02/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1629363734 | (05) | WA |