Provider Demographics
NPI:1750541389
Name:BURTON, CANDACE (OTR)
Entity type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3669
Mailing Address - Country:US
Mailing Address - Phone:541-201-1208
Mailing Address - Fax:541-201-1256
Practice Address - Street 1:135 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1514
Practice Address - Country:US
Practice Address - Phone:541-201-1208
Practice Address - Fax:541-201-1256
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR914218225XH1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors