1538288691 NPI number — DR. DEBORAH LYNN DUNPHY PH.D.

Table of content: DR. DEBORAH LYNN DUNPHY PH.D. (NPI 1538288691)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538288691 NPI number — DR. DEBORAH LYNN DUNPHY PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNPHY
Provider First Name:
DEBORAH
Provider Middle Name:
LYNN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538288691
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2411 N 24TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT VERNON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98273-5867
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-982-2324
Provider Business Mailing Address Fax Number:
360-336-6866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 S 1ST ST
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
MOUNT VERNON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98273-3897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-588-4626
Provider Business Practice Location Address Fax Number:
360-336-3270
Provider Enumeration Date:
03/28/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X , with the licence number:  PY00003347 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TP2701X , with the licence number: PY00003347 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: PY00003347 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)