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Individual

DR. CHRISTOPHER MATHIAS GUNAWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1400 POTTERY AVE, PORT ORCHARD, WA 98366-3711
(360) 895-5000
(877) 516-9023
Mailing address
1400 POTTERY AVE, PORT ORCHARD, WA 98366-3768
(360) 895-5000
(877) 516-9023

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A157790
CA
208000000X
Pediatrics Physician
Primary
MD61537259
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
VAD000
MEDICARE UPIN
Enumeration date
06/05/2017
Last updated
10/18/2024
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