Individual
MS. JACQUELINE JANE BURKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
360 NW BURNSIDE RD, GRESHAM, OR 97030-3852
(503) 667-7480
Mailing address
19765 SE TICKLE CREEK RD, BORING, OR 97009-9516
(503) 866-4520
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H4808
OR
Other
Enumeration date
07/24/2008
Last updated
07/24/2008
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