Healthcare Provider Details

I. General information

NPI: 1225034580
Provider Name (Legal Business Name): PILAR H BUERK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 NW LOVEJOY ST STE 200
PORTLAND OR
97210-2863
US

IV. Provider business mailing address

4103 SW MERCANTILE DR
LAKE OSWEGO OR
97035
US

V. Phone/Fax

Practice location:
  • Phone: 503-227-0671
  • Fax: 503-227-0676
Mailing address:
  • Phone: 503-233-9818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberMD18367
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: