Provider Demographics
NPI:1902603889
Name:BURT, CADE MALONE (CPHT)
Entity type:Individual
Prefix:
First Name:CADE
Middle Name:MALONE
Last Name:BURT
Suffix:
Gender:
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 S 7TH ST APT 505
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-2222
Mailing Address - Country:US
Mailing Address - Phone:205-773-0398
Mailing Address - Fax:
Practice Address - Street 1:518 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-2236
Practice Address - Country:US
Practice Address - Phone:205-773-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA61603324183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician