Organization
CREATE HEATH NW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN ROBERT BURTON DO (DOCTOR)
(971) 344-7365
Entity
Organization
Contact information
Practice address
1975 NW 167TH PL # 100-42, BEAVERTON, OR 97006-4908
(971) 344-7365
Mailing address
1975 NW 167TH PL # 100-42, BEAVERTON, OR 97006-4908
(971) 344-7365
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO171244
OREGON MEDICAL BOARD
OR
01
—
OP60798348
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
08/30/2021
Last updated
08/30/2021
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