Provider Demographics
NPI:1578587044
Name:BURDETTE, LINDA M (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:BURDETTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2947
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98907-2947
Mailing Address - Country:US
Mailing Address - Phone:509-248-7849
Mailing Address - Fax:509-249-5042
Practice Address - Street 1:3003 TIETON DR
Practice Address - Street 2:SUITE 200
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3679
Practice Address - Country:US
Practice Address - Phone:509-454-2229
Practice Address - Fax:509-454-7979
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10000918207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology