Provider Demographics
NPI:1700034964
Name:BURTON, NEAL HOLLAND (MSW)
Entity Type:Individual
Prefix:MR
First Name:NEAL
Middle Name:HOLLAND
Last Name:BURTON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4718 NE 32ND PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-7028
Mailing Address - Country:US
Mailing Address - Phone:206-595-6779
Mailing Address - Fax:
Practice Address - Street 1:65 N HIGHWAY 101 STE 204
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-9371
Practice Address - Country:US
Practice Address - Phone:503-325-0241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker