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NPI Code Detail

MEDICARE: GAYLYN RENE BURKE

MEDICARE: GAYLYN RENE BURKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse10022140OR

General Provider Information

NPI Number : 1063341493
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAYLYN RENE BURKE
Provider Business Mailing Address
First Line : 14725 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-2556
Country : US
Telephone Number : 971-314-0144
Fax Number : 971-200-2073
Provider Business Practice Location Address
First Line : 14725 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-2556
Country : US
Telephone Number : 971-314-0144
Fax Number : 971-200-2073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/19/2026

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Directions to “ GAYLYN RENE BURKE ” Practice Location

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