Provider Demographics
NPI:1033127717
Name:DUNNE, ARDETH LAZZ (PAC)
Entity type:Individual
Prefix:MS
First Name:ARDETH
Middle Name:LAZZ
Last Name:DUNNE
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:1730 MINOR AVENUE
Mailing Address - Street 2:STE 1000 DERMATOLOGY ASSOCIATES PLLC
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1498
Mailing Address - Country:US
Mailing Address - Phone:206-267-2100
Mailing Address - Fax:206-267-2101
Practice Address - Street 1:1730 MINOR AVENUE
Practice Address - Street 2:STE 1000 DERMATOLOGY ASSOCIATES PLLC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1498
Practice Address - Country:US
Practice Address - Phone:206-267-2100
Practice Address - Fax:206-267-2101
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10000724207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8861584Medicare PIN