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Individual

MS. JULIENE BURGESS BOTTOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
4700 POINT FOSDICK DR NW, SUITE 219, GIG HARBOR, WA 98335-1706
(253) 851-7733
Mailing address
4700 POINT FOSDICK DR NW, SUITE 219, GIG HARBOR, WA 98335-1706
(253) 851-7733

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01063
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R143633
MEDICARE PTAN
OR
Enumeration date
01/31/2008
Last updated
05/04/2016
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