Provider Demographics
NPI:1154874428
Name:BURCHARD, JARRED
Entity type:Individual
Prefix:MR
First Name:JARRED
Middle Name:
Last Name:BURCHARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8525 139TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1961
Mailing Address - Country:US
Mailing Address - Phone:206-949-1779
Mailing Address - Fax:
Practice Address - Street 1:8525 139TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1961
Practice Address - Country:US
Practice Address - Phone:206-949-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst