Individual
MS. JACQUELYN MARIE BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5520 BRIDGEPORT WAY, UNIVERSITY PLACE, WA 98467
(253) 566-7166
Mailing address
4560 SE INTERNATIONAL WAY, STE. 100, MILWAUKIE, OR 97222
(971) 206-5202
(971) 206-5203
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0C00000831
WA
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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