Burdulis, Audra Jo
Burdulis, Audra Jo is an individual health care provider with primary practice located at 3600 Lind Ave Sw Ste 170 , Renton WA 98057-4934. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Burdulis, Audra Jo can be contacted via phone (425) 690-3555.Contact Information
Primary practice address
3600 Lind Ave Sw Ste 170
Renton WA 98057-4934
Phone: (425) 690-3555
Fax: (425) 690-9555
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA10004625 | Washington |
Profile Details
| NPI number | 1124075205 |
|---|---|
| LBN Legal business name | Burdulis, Audra Jo |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Aug 17th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124075205 | NPPES |
| Washington | MEDICAID | 2009751 | |
| Washington | Other | G8891360 |
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