Healthcare Provider Details

I. General information

NPI: 1619895604
Provider Name (Legal Business Name): ANNELIE JOAN BURNS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 15TH AVE E
SEATTLE WA
98112-5103
US

IV. Provider business mailing address

258 SE ORCHARD DR APT 204
NORTH BEND WA
98045-5029
US

V. Phone/Fax

Practice location:
  • Phone: 877-752-0423
  • Fax: 855-437-8755
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.RN.61673701.MSL
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: