Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO00002138 | WA |
NPI | 1033772629 |
---|---|
Provider Name | Margaret Wilder Burke |
First Address | Bellingham, WA 98225-1545 |
Second Address | Bellingham, WA 98225-1545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2019 |
Last Update Date | 18/04/2019 |