Basic Information
Provider Information
NPI: 1689614943
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURDEN
FirstName: MARGARET
MiddleName: H.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 709 W ORCHARD DR
Address2: SUIRTE 4
City: BELLINGHAM
State: WA
PostalCode: 982251766
CountryCode: US
TelephoneNumber: 3603188800
FaxNumber: 3603181085
Practice Location
Address1: 1610 GROVER ST
Address2: SUITE D1
City: LYNDEN
State: WA
PostalCode: 982641539
CountryCode: US
TelephoneNumber: 3603541333
FaxNumber: 3603545399
Other Information
ProviderEnumerationDate: 06/07/2006
LastUpdateDate: 06/15/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD00027348WAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
0037601WAREGENCE BLUESHIELDOTHER
08014796001WARAILROAD MEDICAREOTHER
892506301WALABOR & INDUSTRIES (CV)OTHER
811776405WA MEDICAID
012891901WALABOR & INDUSTRIES (REG)OTHER
42389800501WAGROUP HEALTH COOPERATIVEOTHER


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