Individual
GREGORY PAUL BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10201 SE MAIN ST STE 10, PORTLAND, OR 97216
(503) 255-2186
(503) 255-2194
Mailing address
10201 SE MAIN ST STE 10, PORTLAND, OR 97216-2937
(503) 255-2186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD167544
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/31/2011
Last updated
10/03/2018
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