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Individual

KRISTEN NICOLE BURKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3726 BROADWAY STE 201, EVERETT, WA 98201-3788
(425) 317-9119
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
020524
NY
363AS0400X
Surgical Physician Assistant
Primary
PA60803227
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2096348
WA
Enumeration date
02/05/2017
Last updated
05/08/2018
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