Healthcare Provider Details

I. General information

NPI: 1518907393
Provider Name (Legal Business Name): BURDETT M. ROONEY ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10030 SW 210TH ST
VASHON WA
98070-6584
US

IV. Provider business mailing address

PO BOX 3835
SEATTLE WA
98124-3835
US

V. Phone/Fax

Practice location:
  • Phone: 206-463-3671
  • Fax: 206-463-3613
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-762-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30006819
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: