Provider Demographics
NPI:1912065889
Name:BURKEBILE, DAVID LAVERNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LAVERNE
Last Name:BURKEBILE
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 1:2539 BURNETT CT S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5029
Mailing Address - Country:US
Mailing Address - Phone:206-300-9021
Mailing Address - Fax:
Practice Address - Street 1:601 S CARR RD
Practice Address - Street 2:SUITE 420
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5866
Practice Address - Country:US
Practice Address - Phone:253-735-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000108412080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics