Individual
DOROTHY CHADIKA BURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28168 OLD RAINIER RD, RAINIER, OR 97048-3017
(800) 244-4870
Mailing address
253 25TH AVE, LONGVIEW, WA 98632-1215
(678) 760-6321
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN248381
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61486147
WA
Other
Enumeration date
01/08/2019
Last updated
08/06/2024
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