Individual
BRYN LIESE BURGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
35535 6TH PL SW, BIRTH TO THREE DEVELOPMENTAL CENTER, FEDERAL WAY, WA 98023
(253) 874-5445
(253) 874-0687
Mailing address
PO BOX 24269, BIRTH TO THREE DEVELOPMENTAL CENTER, FEDERAL WAY, WA 98093-1269
(253) 874-5445
(253) 874-0687
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0378BU
REGENCE BS
WA
05
—
8436032
—
WA
Enumeration date
11/13/2006
Last updated
07/08/2007
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