Individual
ANDREA CALLIE BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
6125 N OMAHA AVE, PORTLAND, OR 97217-4267
(503) 289-4519
Mailing address
6125 N OMAHA AVE, PORTLAND, OR 97217-4267
(503) 289-4519
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4113
OR
Other
Enumeration date
04/01/2009
Last updated
04/01/2009
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