Provider Demographics
NPI:1518022243
Name:BURROWS, SUE A (LMP)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:A
Last Name:BURROWS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18910 28TH AVE W
Mailing Address - Street 2:SUITE106
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4701
Mailing Address - Country:US
Mailing Address - Phone:425-774-8600
Mailing Address - Fax:425-774-8656
Practice Address - Street 1:18910 28TH AVE W
Practice Address - Street 2:SUITE106
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4701
Practice Address - Country:US
Practice Address - Phone:425-774-8600
Practice Address - Fax:425-774-8656
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008494225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA602128895000Medicare UPIN