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Individual

DR. DAVID BURTON BORK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M-12326
ID
2085R0202X
Diagnostic Radiology Physician
Primary
MD00017381
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1700864014
ID
01
189512
L&I PROVIDER NUMBER
WA
01
189513
L&I PROVIDER NUMBER
WA
01
189514
L&I PROVIDER NUMBER
WA
05
8195000
WA
Enumeration date
01/06/2006
Last updated
07/13/2018
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