MEDICARE: MS. DEBI KAY BURKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1912254376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBI KAY BURKE

Provider Business Mailing Address
First Line	:	PO BOX 993
Second Line	:
City	:	WASHOUGAL
State	:	WA
Zip	:	98671-0923
Country	:	US
Telephone Number	:	360-975-9753
Fax Number	:

Provider Business Practice Location Address
First Line	:	8120 SE LAKE RD
Second Line	:	#20
City	:	PORTLAND
State	:	OR
Zip	:	97267-2310
Country	:	US
Telephone Number	:	503-875-4854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2012
Last Update Date	:	08/04/2012

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Directions to “ MS. DEBI KAY BURKE ” Practice Location

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