# SOUTHLAKE PSYCHIATRIC CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871651042
- **Authorized official:** DR. JOHN EDWARD DUNNE M.D. (OWNER)
- **Authorized official phone:** (425) 235-7383

## Contact information

- **Practice address:** 1400 TALBOT RD S, SUITE 203, RENTON, WA 98055-4291
- **Practice address phone:** (425) 235-7383
- **Practice address fax:** (425) 228-2169
- **Mailing address:** 1400 TALBOT RD S, SUITE 203, RENTON, WA 98055-4291
- **Mailing address phone:** (425) 235-7383
- **Mailing address fax:** (425) 228-2169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 14418 | WA | Yes |

## Other

- **Enumeration date:** 12/04/2006
- **Last updated:** 08/22/2020