Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | PA10000724 | WA |
NPI | 1033127717 |
---|---|
Provider Name | Ms. Ardeth Lazz Dunne |
First Address | Seattle, WA 98101-1498 |
Second Address | Seattle, WA 98101-1498 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 14/03/2008 |