Provider Demographics
NPI:1154901288
Name:BURELO, DENISE DANELLE
Entity type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:DANELLE
Last Name:BURELO
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 1:409 E LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2953
Mailing Address - Country:US
Mailing Address - Phone:425-346-1635
Mailing Address - Fax:
Practice Address - Street 1:409 E LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2953
Practice Address - Country:US
Practice Address - Phone:425-346-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602-816-051171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty