Individual
JEREMY NICHOLAS BURLINGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1150
(503) 528-0800
Mailing address
4820 SW BARBUR BLVD APT 15, PORTLAND, OR 97239-2853
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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