Individual
AUDRA JO BURDULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
108 NW SISEMORE ST STE 120, BEND, OR 97703-2869
(541) 213-2133
Mailing address
600 JEFFERSON ST STE 600, LAFAYETTE, LA 70501-6987
(337) 202-0720
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA10004625
WA
363AM0700X
Medical Physician Assistant
Primary
PA228080
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2009751
—
WA
01
—
G8891360
MEDICARE W VALLEY MEDICAL GROUP - RENTON
WA
Enumeration date
05/27/2006
Last updated
03/20/2026
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