Individual
GLORIA BURKENBINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
4200 6TH AVE SE, SUITE 202, LACEY, WA 98503-1042
(360) 539-7726
(360) 539-7729
Mailing address
4200 6TH AVE SE STE 202, LACEY, WA 98503-1042
(360) 539-7726
(360) 539-7729
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00024646
WA
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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