Provider Demographics
NPI:1982376018
Name:BURR, MONICA LINCOPAN
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:LINCOPAN
Last Name:BURR
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 1:11611 SE 231ST PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-3691
Mailing Address - Country:US
Mailing Address - Phone:206-683-5989
Mailing Address - Fax:
Practice Address - Street 1:11611 SE 231ST PL
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-3691
Practice Address - Country:US
Practice Address - Phone:206-683-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC55695171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter