Provider Demographics
NPI:1902097025
Name:BURKE, ANDREA B (DMD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:B
Last Name:BURKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BOX 357191
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:206-744-3189
Mailing Address - Fax:206-744-2810
Practice Address - Street 1:325 9TH AVE FL 4
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-3189
Practice Address - Fax:206-744-2810
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAD-9493204E00000X
WAMD60711004204E00000X
WADE60713032204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2072939Medicaid