Individual
MICHELLE BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(540) 296-7235
Mailing address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 296-7235
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
186725
OR
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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