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General NPI Number Information
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NPI Number | 1013936574
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Entity Type | Individual
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Provider Name | TAMELA RENEE BURRELL-VERBARG O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 17100 STATE ROUTE 507 SE
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City | YELM
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State | WA
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Zip | 98597-7605
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Country | US
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Telephone | 360-583-6568
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 HUDSON ST NW
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City | OLYMPIA
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State | WA
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Zip | 98502-9022
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Country | US
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Telephone | 360-919-3061
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT11939T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD6100320
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0003341
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License Number State | CO
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