Individual
DAVID BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
15640 NW LAIDLAW RD STE 102, PORTLAND, OR 97229-3828
(503) 764-0100
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201607358NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500715385
—
OR
Enumeration date
10/05/2016
Last updated
02/15/2021
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