Provider Demographics
NPI:1356583660
Name:BURNS, RASHAE PATRICE (CMA, CHW, PBT)
Entity type:Individual
Prefix:
First Name:RASHAE
Middle Name:PATRICE
Last Name:BURNS
Suffix:
Gender:F
Credentials:CMA, CHW, PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 N FORTUNE AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-2601
Mailing Address - Country:US
Mailing Address - Phone:503-957-8098
Mailing Address - Fax:
Practice Address - Street 1:8939 N FORTUNE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-2601
Practice Address - Country:US
Practice Address - Phone:503-957-8098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR108976172V00000X
246RP1900X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172V00000XOther Service ProvidersCommunity Health Worker
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy