Individual
CARISSA BURKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3530 SE 136TH AVE APT 5, PORTLAND, OR 97236-2958
(503) 719-4535
(503) 719-4537
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(260) 224-3354
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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