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General NPI Number Information
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NPI Number | 1467662643
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Entity Type | Individual
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Provider Name | REBECCA DAIL BURKE PHD, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8507 NE 8TH WAY
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City | VANCOUVER
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State | WA
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Zip | 98664-1980
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Country | US
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Telephone | 360-254-5335
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Fax |
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Provider Business Mailing Address
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Address Line | 3708 NE 56TH ST
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City | VANCOUVER
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State | WA
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Zip | 98661-2048
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Country | US
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Telephone | 360-696-9075
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | LL00004258
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License Number State | WA
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