Bryn Liese Burge, MS CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00003791 Issued in WA

Practice address

35535 6TH PL SW
Birth to Three Developmental Center
Federal Way, WA 98023

Phone

(253) 874-5445

Fax

(253) 874-0687

NPI assigned

Nov 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Birth to Three Developmental Center

  • Physical Therapy Clinic/Center
  • Federal Way, WA
  • NPI 1609936624
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801967534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24269",
            "address_2": "BIRTH TO THREE DEVELOPMENTAL CENTER",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980931269",
            "telephone_number": "253-874-5445",
            "fax_number": "253-874-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35535 6TH PL SW",
            "address_2": "BIRTH TO THREE DEVELOPMENTAL CENTER",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98023",
            "telephone_number": "253-874-5445",
            "fax_number": "253-874-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGE",
        "first_name": "BRYN",
        "middle_name": "LIESE",
        "credential": "MS CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8436032",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BS",
            "identifier": "0378BU",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ai-Hien Thi Bui, D.O.
• Tam Bui, D.O
• Erin Elizabeth Buley
• Luci Bullock
• Julien R Buonanno, OTD, OTR/L
• Jennifer Burkman
• Candace J Burnikel, L.AC.
• Laron Burris
• Michael C Burt, DC
• Jasmine Burtner, LMP

• Speech-Language Pathologist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.