Provider Demographics
NPI:1336323252
Name:GEORGE FOX UNIVERSITY
Entity Type:Organization
Organization Name:GEORGE FOX UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH AND COUNSELING
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BURHOW
Authorized Official - Suffix:JR
Authorized Official - Credentials:PSYD
Authorized Official - Phone:503-554-2340
Mailing Address - Street 1:414 N MERIDIAN ST # 6128
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2697
Mailing Address - Country:US
Mailing Address - Phone:503-554-2340
Mailing Address - Fax:503-554-2343
Practice Address - Street 1:414 N MERIDIAN ST # 6128
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2697
Practice Address - Country:US
Practice Address - Phone:503-554-2340
Practice Address - Fax:503-554-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP20937Medicare UPIN