Individual
ELENA MOYLE BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-4207
(503) 494-2759
Mailing address
3939 SW BOND AVE APT 209, PORTLAND, OR 97239-4596
(775) 378-5701
Taxonomy
Speciality
Code
Description
License number
State
282NW0100X
Women's Hospital
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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