Gunderson, Patricia L.

Gunderson, Patricia L. is an individual health care provider with primary practice located at 850 Maple Street , Medical Lake WA 99022-0800. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gunderson, Patricia L. can be contacted via phone (509) 565-4000.

Contact Information

Primary practice address
850 Maple Street Medical Lake WA 99022-0800
Fax: (509) 565-7015
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY00001727 Washington

Profile Details

NPI number 1053393652
LBN Legal business name Gunderson, Patricia L.
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Jan 29th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053393652 NPPES
Washington MEDICAID 8388266

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