Organization
TRAVIS SCOTT BURCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELYNDA OWENS (BILLING & CREDENTIALING MANAGER)
(541) 500-8655
Entity
Organization
Contact information
Practice address
1040 CRATER LAKE AVE STE D, MEDFORD, OR 97504-6295
(541) 500-8655
Mailing address
PO BOX 4752, MEDFORD, OR 97501-0197
(541) 500-8655
(800) 433-1396
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/29/2020
Last updated
01/28/2025
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