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General NPI Number Information
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NPI Number | 1750863353
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Entity Type | Individual
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Provider Name | MATEA NICHOLE BURNS AU.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 418 1ST AVE W
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City | SEATTLE
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State | WA
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Zip | 98119-4018
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Country | US
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Telephone | 206-452-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 11511 NE 10TH ST
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City | BELLEVUE
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State | WA
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Zip | 98004-8578
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Country | US
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Telephone | 425-502-3000
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Fax | 425-502-3589
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 60881074
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | LD60881074
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License Number State | WA
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