Provider Demographics
NPI:1528206711
Name:SLUSARZ BURT, JESSICA V (MPH)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:V
Last Name:SLUSARZ BURT
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:V
Other - Last Name:BURT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPH
Mailing Address - Street 1:3020 RUCKER AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3900
Mailing Address - Country:US
Mailing Address - Phone:425-339-8692
Mailing Address - Fax:425-339-5253
Practice Address - Street 1:3020 RUCKER AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3900
Practice Address - Country:US
Practice Address - Phone:425-339-8692
Practice Address - Fax:425-339-5253
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker