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General NPI Number Information
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NPI Number | 1073900403
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Entity Type | Organization
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Legal Business Name | ROBERT K. BURLINGAME, M.D., P.C.
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 100 E 13TH ST SUITE 101
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City | VANCOUVER
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State | WA
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Zip | 98660-3326
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Country | US
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Telephone | 360-256-3686
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Fax | 360-694-4681
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Provider Business Mailing Address
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Address Line | PO BOX 2129
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City | VANCOUVER
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State | WA
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Zip | 98668-2129
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Country | US
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Telephone | 360-256-3686
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Fax | 360-694-4681
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ROBERT KELLEY BURLINGAME
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Credential | M.D.
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Telephone | 360-256-3686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00027023
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License Number State | WA
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