Individual
HEATHER ANN CAREFOOT BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8060
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8060
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201503213CRNA-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201503212RN
REGISTERED NURSE LICENSE
OR
01
—
201503213CRNA-PP
CERTIFIED REGISTERED NURSE ANESTHETIST LICENSE
OR
Enumeration date
04/17/2014
Last updated
10/29/2015
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