Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | HL00007067 | WA |
NPI | 1003260704 |
---|---|
Provider Name | Gina Dunn |
First Address | Seattle, WA 98124-3835 |
Second Address | Seattle, WA 98144-2712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 19/04/2016 |