Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 60418 | OR |
NPI | 1033525019 |
---|---|
Provider Name | Olga Burger |
First Address | Lake Oswego, OR 97035-2371 |
Second Address | Lake Oswego, OR 97035-2371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2014 |
Last Update Date | 10/07/2014 |