Individual
ELIJAH BURBANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-4101
Mailing address
20920 SE 216TH WAY, MAPLE VALLEY, WA 98038-6454
(253) 441-1981
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD61066706
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2012
Last updated
10/21/2020
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