Healthcare Provider Details
I. General information
NPI: 1568069656
Provider Name (Legal Business Name): ALLIE BURKE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2020
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16259 SYLVESTER RD SW STE 505
BURIEN WA
98166-3059
US
IV. Provider business mailing address
16259 SYLVESTER RD SW STE 505
BURIEN WA
98166-3059
US
V. Phone/Fax
- Phone: 206-242-3696
- Fax:
- Phone: 206-242-3696
- Fax: 206-246-1078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | LD61096972 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: