Individual
ELIZABETH BURDZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP-R
Contact information
Practice address
1438 SE DIVISION ST, PORTLAND, OR 97202-1140
(503) 548-0346
(503) 232-5959
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MG61213616
WA
101YM0800X
Mental Health Counselor
Primary
24-QMHP-R-2549
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500825220
—
OR
Enumeration date
06/17/2021
Last updated
01/12/2024
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