Individual
AUTUMN BURTRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11611 NE AINSWORTH CIR, PORTLAND, OR 97220-9017
(707) 601-8695
Mailing address
11611 NE AINSWORTH CIR, PORTLAND, OR 97220-9017
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
A0820
OR
235Z00000X
Speech-Language Pathologist
Primary
18878
OR
Other
Enumeration date
04/18/2023
Last updated
07/28/2026
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