Healthcare Provider Details
I. General information
NPI: 1548187107
Provider Name (Legal Business Name): DAVID ERIC BURKHART
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 MAIN ST
OREGON CITY OR
97045-1818
US
IV. Provider business mailing address
516 13TH ST APT 2
OREGON CITY OR
97045-1607
US
V. Phone/Fax
- Phone: 971-320-1828
- Fax: 503-212-6312
- Phone: 971-378-8809
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | 114800 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: