Individual
DAVID BURNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3650 NE MALLORY AVE APT 101, PORTLAND, OR 97212-3088
(971) 245-0798
Mailing address
4941 NE 17TH AVE, PORTLAND, OR 97211-5709
(503) 282-3296
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
T-20-392
OR
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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