Provider Demographics
NPI:1073900403
Name:ROBERT K. BURLINGAME, M.D., P.C.
Entity Type:Organization
Organization Name:ROBERT K. BURLINGAME, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KELLEY
Authorized Official - Last Name:BURLINGAME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-256-3686
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-2129
Mailing Address - Country:US
Mailing Address - Phone:360-256-3686
Mailing Address - Fax:360-694-4681
Practice Address - Street 1:100 E 13TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3326
Practice Address - Country:US
Practice Address - Phone:360-256-3686
Practice Address - Fax:360-694-4681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000270232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty