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Individual

CAROL ANN BURCKHARDT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
727 W BURNSIDE, PORTLAND, OR 97209
(503) 228-4533
Mailing address
244 GREENRIDGE DR., LAKE OSWEGO, OR 97035
(503) 228-4533

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
083040504N6
OR

Other

Enumeration date
05/04/2006
Last updated
07/08/2007
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