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Individual

AMY MARIE BURGARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2555 SILVERTON RD NE, SALEM, OR 97301-0837
(503) 393-4273
Mailing address
1115 MADISON ST NE # 222, SALEM, OR 97301-7862
(503) 393-4273

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000004327
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
THW000004327
TRADITIONAL HEALTH WORKER REGISTRY
OR
Enumeration date
02/03/2021
Last updated
02/03/2021
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