Healthcare Provider Details

I. General information

NPI: 1194216366
Provider Name (Legal Business Name): MOLLY BURGER DORROH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MOLLY WOODS BURGER DO

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 S 23RD ST STE 300
TACOMA WA
98405-1602
US

IV. Provider business mailing address

3209 S 23RD ST STE 300
TACOMA WA
98405-1602
US

V. Phone/Fax

Practice location:
  • Phone: 253-301-5560
  • Fax:
Mailing address:
  • Phone: 253-301-5560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberDO.DO.61537859
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: