Provider Demographics
NPI:1396435012
Name:BURNS, BRIDGET A
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:A
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10447 65TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-2506
Mailing Address - Country:US
Mailing Address - Phone:206-403-8747
Mailing Address - Fax:
Practice Address - Street 1:6700 S LANGSTON RD
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-5012
Practice Address - Country:US
Practice Address - Phone:206-403-8747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health