Healthcare Provider Details

I. General information

NPI: 1902097025
Provider Name (Legal Business Name): ANDREA B BURKE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE FL 4
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

1959 NE PACIFIC ST BOX 357191
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3189
  • Fax: 206-744-2810
Mailing address:
  • Phone: 206-744-3189
  • Fax: 206-744-2810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberD-9493
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberMD60711004
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDE60713032
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: