Provider Demographics
NPI:1205905262
Name:BURNS, DAVID W (DC, ND)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:BURNS
Suffix:
Gender:M
Credentials:DC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 24TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7367
Mailing Address - Country:US
Mailing Address - Phone:425-518-9077
Mailing Address - Fax:
Practice Address - Street 1:5712 E LAKE SAMMAMISH PKWY SE STE 106
Practice Address - Street 2:SUITE 2
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-8943
Practice Address - Country:US
Practice Address - Phone:425-518-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH3657111NN0400X
WANT60096656175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8858878Medicare UPIN