Individual
MRS. ANDREA ALYS BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 BROADWAY SWEDISH MAXILLOFACIAL SURGERY, SUITE 460, SEATTLE, WA 98122
(206) 320-2078
(206) 386-3296
Mailing address
600 BROADWAY, SUITE 460, SEATTLE, WA 98122
(206) 320-2078
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA60800587
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831557107
—
WA
Enumeration date
02/02/2016
Last updated
07/25/2018
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