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1124712377
RANDALL JOSEPH BURNETT
GRESHAM, OR
NPI
1124712377
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2023-06-08
Last Update Date
2023-06-08
Business Address
RANDALL JOSEPH BURNETT
831 NW COUNCIL DR STE 300
GRESHAM, OR 97030-3725
Phone number: 460-050-3258
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Mailing Address
RANDALL JOSEPH BURNETT
11035 NE SANDY BLVD
PORTLAND, OR 97220-2553
Phone number: 503-258-4200
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