Provider Demographics
NPI:1386788123
Name:BURTON, GAY NAGANUMA (PT)
Entity type:Individual
Prefix:
First Name:GAY
Middle Name:NAGANUMA
Last Name:BURTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GAY
Other - Middle Name:
Other - Last Name:NAGANUMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1850 BOYER AVE E
Mailing Address - Street 2:BOYER CHILDREN'S CLINIC
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-2922
Mailing Address - Country:US
Mailing Address - Phone:206-325-8477
Mailing Address - Fax:206-323-1385
Practice Address - Street 1:1850 BOYER AVE E
Practice Address - Street 2:BOYER CHILDREN'S CLINIC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-2922
Practice Address - Country:US
Practice Address - Phone:206-325-8477
Practice Address - Fax:206-323-1385
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist