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Individual

BRENDA LYNN BURDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
14050 JUANITA DR NE, SUITE A, KIRKLAND, WA 98034-9708
(425) 820-2020
(425) 821-9576
Mailing address
14050 JUANITA DR NE, SUITE A, KIRKLAND, WA 98034-9708
(425) 820-2020
(425) 821-9576

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TX3126
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11719788
CAQH PERSONAL ID#
WA
01
1760526628
NPI PERSONAL
WA
01
1831822
CHPW INDIVIDUAL ID#
WA
05
2021087
WA
01
G8881012
MEDICARE INDIVIDUAL PTAN
WA
01
P00792547
RAILROAD MEDICARE INDIVIDUAL
WA
Enumeration date
02/16/2007
Last updated
03/07/2023
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