Individual
CONNIE LYNN BURGSTAHLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4916 NE ST JOHNS RD, VANCOUVER, WA 98661-2547
(360) 903-2623
Mailing address
4916 NE ST JOHNS RD, VANCOUVER, WA 98661-2547
(360) 903-2623
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
600 597 354
WA
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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