Individual
MR. TRAVIS DAVID BURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
1838 PORTER ST, ENUMCLAW, WA 98022
(206) 979-3160
Mailing address
1838 PORTER ST, ENUMCLAW, WA 98022
(206) 979-3160
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60259571
WA
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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