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NPI Code Detail

MEDICARE: DR. JENNIFER M BURSTAIN M.D.

MEDICARE: DR. JENNIFER M BURSTAIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician33047IA
2101Y00000XCounselorWA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477666485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER M BURSTAIN M.D.
Provider Business Mailing Address
First Line : 999 164TH AVE NE
Second Line :
City : BELLEVUE
State : WA
Zip : 98008-3518
Country : US
Telephone Number : 425-586-2338
Fax Number : 425-957-0351
Provider Business Practice Location Address
First Line : 1911 1ST AVE SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-5320
Country : US
Telephone Number : 319-366-1503
Fax Number : 319-366-6976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 09/13/2021

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