Provider Demographics
NPI:1861911463
Name:BURGHARDT, EMILY CATHERINE (PT,DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CATHERINE
Last Name:BURGHARDT
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 228TH AVE SE STE B
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-9328
Mailing Address - Country:US
Mailing Address - Phone:425-391-4488
Mailing Address - Fax:425-391-8287
Practice Address - Street 1:2850 228TH AVE SE STE B
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-9328
Practice Address - Country:US
Practice Address - Phone:425-391-4488
Practice Address - Fax:425-391-8287
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60768579225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist