Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 6541 | OR |
N | 2251S0007X | Physical Therapist - Sports | 6541 | OR |
Y | 2251X0800X | Physical Therapist - Orthopedic | 6541 | OR |
NPI | 1083998512 |
---|---|
Provider Name | Margaret Florence Berry Burette |
First Address | Portland, OR 97219-5290 |
Second Address | Portland, OR 97219-5290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2011 |
Last Update Date | 03/10/2011 |