MEDICARE: DAVID KAMAKAKIHEALANI BURCHETT PHARMD

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
1	183500000X	Pharmacist	PH 60018782	WA

General Provider Information

NPI Number	:	1750658357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID KAMAKAKIHEALANI BURCHETT PHARMD

Provider Business Mailing Address
First Line	:	911 S 91ST AVE
Second Line	:	#2
City	:	YAKIMA
State	:	WA
Zip	:	98908-8451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2304 E NOB HILL BLVD
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-9502
Country	:	US
Telephone Number	:	509-575-7552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2011
Last Update Date	:	11/27/2011

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