Provider Demographics
NPI:1053858852
Name:DUNNING, KERIANN
Entity type:Individual
Prefix:
First Name:KERIANN
Middle Name:
Last Name:DUNNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 NE MANITOU PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1336
Mailing Address - Country:US
Mailing Address - Phone:425-308-9833
Mailing Address - Fax:
Practice Address - Street 1:10701 NE MANITOU PARK BLVD
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1336
Practice Address - Country:US
Practice Address - Phone:425-308-9833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI 60410648133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered