NPI 1003186693

Travis David Burt, LMP

Practitioner Specialist Enumclaw, WA

Practice location

Address: 1838 Porter St, Enumclaw, WA 98022
Phone: (206) 979-3160

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence MA60259571 (WA)

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Registry record

NPI: 1003186693
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jan 2012
Record last updated: 12 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.