Active NPI
Martin Lee David Gunn
- Diagnostic Radiology Physician
- Seattle, WA
National Provider Identifier
1104983303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- TR00041282
- Practice address
- 1959 NE Pacific St
Seattle, WA 98195-0001 - Phone
- (206) 520-5000
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | TR00041282 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St
Seattle, WA 98195-0001
Mailing address
PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420
Other practice location 1
Harborview Medical Center
325 9th Ave
Seattle, WA 98104
Phone (206) 731-3105
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 294930 | Other | INTERNAL ID-MOTOR VEHICLE ID | |
| 1104983303 | Medicaid | WA | |
| 0231119 | Other | WA | L&I |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1104983303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50095",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981455095",
"telephone_number": "206-543-6420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950001",
"telephone_number": "206-520-5000"
}
],
"practiceLocations": [
{
"address_1": "Harborview Medical Center",
"address_2": "325 9th Ave",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "98104",
"country_code": "US",
"telephone_number": "206-731-3105",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUNN",
"first_name": "MARTIN",
"middle_name": "LEE DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "TR00041282",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL ID-MOTOR VEHICLE ID",
"identifier": "294930",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104983303",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0231119",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.