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General NPI Number Information
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NPI Number | 1497744684
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Entity Type | Individual
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Provider Name | LEE BURNSIDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 64 RAINIER AVE S
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City | RENTON
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State | WA
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Zip | 98057-2047
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 64 RAINIER AVE S
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City | RENTON
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State | WA
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Zip | 98057-2047
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Country | US
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Telephone | 425-224-2144
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Fax | 425-341-9653
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00033954
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | MD33954
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD33954
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License Number State | WA
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