Provider Demographics
NPI:1528138930
Name:CASEY-BURKE, MARIE ANNE (ARNP)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:ANNE
Last Name:CASEY-BURKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CLINIC #10331
Mailing Address - Street 2:531 QUEEN ANNE AVENUE N
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109
Mailing Address - Country:US
Mailing Address - Phone:206-284-7286
Mailing Address - Fax:
Practice Address - Street 1:CLINIC #10331
Practice Address - Street 2:531 QUEEN ANNE AVENUE N
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109
Practice Address - Country:US
Practice Address - Phone:206-284-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9622226Medicaid
MC0995627OtherDEA
MC0995627OtherDEA