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General NPI Number Information
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NPI Number | 1811100829
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Entity Type | Individual
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Provider Name | SUSAN MELOCKOFF BURKE ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 12040 NE 128TH ST MS # 6
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City | KIRKLAND
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State | WA
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Zip | 98034-3013
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Country | US
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Telephone | 425-899-1874
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Fax | 425-899-1877
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Provider Business Mailing Address
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Address Line | 2201 E REPUBLICAN ST
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City | SEATTLE
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State | WA
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Zip | 98112-4005
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Country | US
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Telephone | 206-324-5099
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP30003852
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License Number State | WA
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