Provider Demographics
NPI:1780812453
Name:BURNS, KARA LEANNE (LMP)
Entity type:Individual
Prefix:MISS
First Name:KARA
Middle Name:LEANNE
Last Name:BURNS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8824
Mailing Address - Country:US
Mailing Address - Phone:509-460-8326
Mailing Address - Fax:
Practice Address - Street 1:524 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-8824
Practice Address - Country:US
Practice Address - Phone:509-460-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60092686225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist