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NPI Code Detail

MEDICARE: DR. ANONG YORD BURKE MD

MEDICARE: DR. ANONG YORD BURKE MD
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
1207Q00000XFamily Medicine PhysicianMD160306OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932205556
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANONG YORD BURKE MD
Provider Business Mailing Address
First Line : 1776 SW MADISON ST
Second Line :
City : PORTLAND
State : OR
Zip : 97205-1715
Country : US
Telephone Number : 503-224-1044
Fax Number : 503-621-2235
Provider Business Practice Location Address
First Line : 12360 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97233-1042
Country : US
Telephone Number : 971-279-4800
Fax Number : 971-279-2051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 01/20/2023

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Directions to “ DR. ANONG YORD BURKE MD” Practice Location

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