Healthcare Provider Details

I. General information

NPI: 1609130392
Provider Name (Legal Business Name): ANDREA LEIGH BURAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 NE GLISAN ST STE 11N
PORTLAND OR
97213-2933
US

IV. Provider business mailing address

4805 NE GLISAN ST STE 11N
PORTLAND OR
97213-2933
US

V. Phone/Fax

Practice location:
  • Phone: 503-215-2075
  • Fax:
Mailing address:
  • Phone: 503-215-2075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301100819
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number4301100819
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD218052
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: