| Burstein-rose Pc | |
|
833 Sw 11th Ave Ste 710 Portland OR 97205-2121 | |
| (503) 701-1050 | |
| Not Available |
| Full Name | Burstein-rose Pc |
|---|---|
| Speciality | Social Worker |
| Location | 833 Sw 11th Ave Ste 710, Portland, Oregon |
| Authorized Official Name and Position | Guy David Burstein (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5037011050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Burstein-rose Pc 833 Sw 11th Ave Ste 710 Portland OR 97205-2121 Ph: (503) 701-1050 | Burstein-rose Pc 833 Sw 11th Ave Ste 710 Portland OR 97205-2121 Ph: (503) 701-1050 |
| NPI Number | 1972917458 |
|---|---|
| Provider Enumeration Date | 06/12/2014 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Medicare PECOS PAC ID | 0446697254 |
|---|---|
| Medicare Enrollment ID | O20240327004161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972917458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2931 (Oregon) | Primary |
| Provider Name | Christina Opal Rose |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437235900 PECOS PAC ID: 2264879071 Enrollment ID: I20240403002859 |
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