Individual
FREDERICK JOHN GUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 S 2ND AVE, WALLA WALLA, WA 99362-4116
(509) 897-3000
(509) 897-5898
Mailing address
1025 S 2ND AVE, WALLA WALLA, WA 99362-4116
(509) 897-3000
(509) 897-5898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00026780
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0242279
L & I
WA
01
—
2221GU
REGENCE
WA
05
—
8602476
—
WA
01
—
8949248
L& I CRIME VICTIMS
WA
Enumeration date
01/17/2007
Last updated
05/25/2021
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