=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477826691
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRANDI ANNE BURLAND D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2012
-----------------------------------------------------
Last Update Date | 03/09/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10600 SE MCLOUGHLIN BLVD SUITE 101
-----------------------------------------------------
City | MILWAUKIE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97222-7428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-974-9777
-----------------------------------------------------
Fax | 503-303-5269
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10600 SE MCLOUGHLIN BLVD SUITE 101
-----------------------------------------------------
City | MILWAUKIE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97222-7428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-974-9777
-----------------------------------------------------
Fax | 503-303-5269
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 5035
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------