Individual
KELLI BURGAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2621 NE 134TH ST STE 140, VANCOUVER, WA 98686-3036
(360) 504-0122
Mailing address
1401 NW 113TH ST, VANCOUVER, WA 98685-3758
(503) 572-3560
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6108360
WA
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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