Provider Demographics
NPI:1508284969
Name:BURT, ALISON JANE (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JANE
Last Name:BURT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9709 3RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2062
Mailing Address - Country:US
Mailing Address - Phone:206-860-4700
Mailing Address - Fax:206-624-9520
Practice Address - Street 1:9709 3RD AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2062
Practice Address - Country:US
Practice Address - Phone:206-860-4700
Practice Address - Fax:206-624-9520
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61083901207RH0002X
FLME130365207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLXF78YOtherBLUE CROSS BLUE SHIELD
FL104064600Medicaid