Provider Demographics
NPI:1942639380
Name:BURDICK, BRITTANY (LMT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BURDICK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3644 SW TROY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1684
Mailing Address - Country:US
Mailing Address - Phone:503-708-6160
Mailing Address - Fax:503-977-0502
Practice Address - Street 1:3644 SW TROY ST STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1684
Practice Address - Country:US
Practice Address - Phone:503-708-6160
Practice Address - Fax:503-977-0502
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19321225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist