Organization
SOUTHLAKE PSYCHIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN EDWARD DUNNE M.D. (OWNER)
(425) 235-7383
Entity
Organization
Contact information
Practice address
1400 TALBOT RD S, SUITE 203, RENTON, WA 98055-4291
(425) 235-7383
(425) 228-2169
Mailing address
1400 TALBOT RD S, SUITE 203, RENTON, WA 98055-4291
(425) 235-7383
(425) 228-2169
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
14418
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191845
L & I
WA
05
—
1228600
—
WA
Enumeration date
12/04/2006
Last updated
08/22/2020
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