Provider Demographics
NPI:1356820997
Name:BURRIS, CLAIRE JULIA (PA-C)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:JULIA
Last Name:BURRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:JULIA
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:1708 YAKIMA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5300
Mailing Address - Country:US
Mailing Address - Phone:253-552-1200
Mailing Address - Fax:253-750-6100
Practice Address - Street 1:1708 YAKIMA AVE STE 105
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5300
Practice Address - Country:US
Practice Address - Phone:253-552-1200
Practice Address - Fax:253-750-6100
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60867603363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2112552Medicaid