Provider Demographics
NPI:1659321354
Name:GUNSHEFSKI, LINDA A (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:GUNSHEFSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3131
Mailing Address - Country:US
Mailing Address - Phone:509-525-2100
Mailing Address - Fax:509-522-0313
Practice Address - Street 1:299 W TIETAN ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4363
Practice Address - Country:US
Practice Address - Phone:509-525-2100
Practice Address - Fax:509-522-0313
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00013593207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAF08069Medicare UPIN
WA5747270001Medicare NSC