Provider Demographics
NPI:1003062365
Name:BURT, MEGHAN (MA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:BURT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6556 20TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-5704
Mailing Address - Country:US
Mailing Address - Phone:360-480-6550
Mailing Address - Fax:
Practice Address - Street 1:1015 NE 113TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6454
Practice Address - Country:US
Practice Address - Phone:360-480-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health