Individual
SCOTT BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 408-4703
Mailing address
9830 NE CASCADES PKWY STE 200, PORTLAND, OR 97220-6834
(503) 239-8101
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201041512RN
OR
Other
Enumeration date
08/31/2010
Last updated
03/30/2011
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