Provider Demographics
NPI:1760546774
Name:BURNETT, CURTIS STOWELL (MD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:STOWELL
Last Name:BURNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16259 SYLVESTER RD SW
Mailing Address - Street 2:#401
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3059
Mailing Address - Country:US
Mailing Address - Phone:206-241-9465
Mailing Address - Fax:206-241-9467
Practice Address - Street 1:16259 SYLVESTER RD SW
Practice Address - Street 2:#401
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98166-3059
Practice Address - Country:US
Practice Address - Phone:206-241-9465
Practice Address - Fax:206-241-9467
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA23524207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1033398Medicaid
WA060005809OtherRR MEDICARE
WA060005809OtherRR MEDICARE
WA1033398Medicaid