Individual
JESSICA SADIE BURCHETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11261 NE KNOTT ST, PORTLAND, OR 97220-1704
(503) 253-8883
Mailing address
11261 NE KNOTT ST, PORTLAND, OR 97220-1704
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/24/2011
Last updated
06/01/2011
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