Provider Demographics
NPI:1033525019
Name:BURGER, OLGA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:BURGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 KINGSGATE RD
Mailing Address - Street 2:B11
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2371
Mailing Address - Country:US
Mailing Address - Phone:661-678-3822
Mailing Address - Fax:
Practice Address - Street 1:97 KINGSGATE RD
Practice Address - Street 2:B11
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2371
Practice Address - Country:US
Practice Address - Phone:661-678-3822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR604182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic