Active NPI
Laurie A. Burke, PH.D.
- Psychologist
- Portland, OR
National Provider Identifier
1649645847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2601
- Practice address
- 11501 SW Pacific Hwy
Suite 100-13
Portland, OR 97223-8649 - Phone
- (503) 673-1848
- NPI assigned
- Dec 14, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2601 | OR | Primary |
Addresses
Primary practice location
11501 SW Pacific Hwy
Suite 100-13
Portland, OR 97223-8649
Mailing address
11501 SW Pacific Hwy
Suite 100-13
Portland, OR 97223-8649
Phone (503) 673-1848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 5, 2018 through Jun 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2601 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450051200000",
"number": "1649645847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11501 SW PACIFIC HWY",
"address_2": "SUITE 100-13",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972238649",
"telephone_number": "503-673-1848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11501 SW PACIFIC HWY",
"address_2": "SUITE 100-13",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972238649",
"telephone_number": "503-673-1848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "LAURIE",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-14",
"last_updated": "2015-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "2601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.