Individual
DALE EUGENE FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
501 W 4TH AVE, TOPPENISH, WA 98948-1615
(509) 865-3141
(509) 865-7388
Mailing address
501 W 4TH AVE, TOPPENISH, WA 98948-1615
(509) 865-3141
(509) 865-7388
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00006443
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0178562
LABOR & IND. PIN #
WA
01
—
0178563
LABOR & IND. GROUP #
WA
01
—
12566
GROUP HEALTH PIN #
WA
01
—
2400
GROUP HEALTH GROUP #
WA
05
—
7123979
—
WA
01
—
8208FU
BLUE SHIELD PIN #
WA
05
—
8397143
—
WA
01
—
R12118
UPIN
WA
Enumeration date
01/19/2007
Last updated
07/09/2007
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