Paul Gunderson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00016113 Issued in WA

Practice address

27129 SE 456TH St
Enumclaw, WA 98022-9335

Phone

(253) 332-6275

NPI assigned

Jan 12, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1669243036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27129 SE 456TH ST",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980229335",
            "telephone_number": "253-332-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27129 SE 456TH ST",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980229335",
            "telephone_number": "253-332-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00016113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kashish Goyal
• Ruth Janette Graham, M.A.
• Robert C Gramann, MD
• Vera Grant, PAC
• Joan D. Green Ferguson, MS ED, LMHC
• Gina Lanore Gwerder, ARNP
• Thomas Hagan
• Sara L Hall, CNM
• Stacey Hancock, L.M.P.
• Jennifer Hannaford, PCD (NAPS)

• Surgery Physician in Enumclaw, WA
• Providers in Enumclaw, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.