Individual
CRYSTAL BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1176
Mailing address
PO BOX 3007, PORTLAND, OR 97208-3007
(503) 535-1176
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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