Jennifer Nicole Bunker
Individual provider Active NPI Counselor · Walla Walla, WA
NPI 1669602017 · NPPES record last updated Jul 20, 2009
Key facts
- NPI
- 1669602017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- RC 60097803 (WA)
- Practice address
- 1316 S Howard St
Walla Walla, WA 99362-4148 - Phone
- (509) 386-0458
- NPI assigned
- Jul 20, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC 60097803 | WA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC 60097803 | WA | Yes |
Addresses
Primary practice location
1316 S Howard St
Walla Walla, WA 99362-4148
Mailing address
1316 S Howard St
Walla Walla, WA 99362-4148
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.