Provider Demographics
NPI:1669625083
Name:BURSCH, PATRICIA MARIE (RNSA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:BURSCH
Suffix:
Gender:F
Credentials:RNSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 GRIFFIN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-2373
Mailing Address - Country:US
Mailing Address - Phone:360-825-7500
Mailing Address - Fax:360-825-3370
Practice Address - Street 1:2820 GRIFFIN AVE STE 210
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2373
Practice Address - Country:US
Practice Address - Phone:360-825-7500
Practice Address - Fax:360-825-3370
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00058788163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0032165OtherLABOR & INDUSTRIES