Individual
MRS. KIMBERLY LAINE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP
Contact information
Practice address
4560 SE INTERNATIONAL WAY, STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5200
Mailing address
6800 132ND PL SE UNIT E302, NEWCASTLE, WA 98059-9111
(817) 995-4275
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
102554
TX
Other
Enumeration date
01/18/2008
Last updated
12/22/2009
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