| Doctor Name: | DR. NATHANIEL BURT |
| NPI Number: | 1619379310 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PY60287726 |
| Business Practice Address: | 3420 Ne Sand Hill Rd Belfair, WA - 985289007 |
| Business Phone Number: | 3602772414 |
| Business Fax Number: | |
| Mailing Address: | 26167 Miller Bay Rd Ne, KINGSTON |
| State: | WA |
| Postal Code: | 983469404 |
| Phone Number: | 3608602321 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2014 |
| NPI Last Update Date: | 09/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY60287726 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |