Healthcare Provider Details

I. General information

NPI: 1558526038
Provider Name (Legal Business Name): AARON NICKOLAS BOREN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6902 SE LAKE RD SUITE 200
MILWAUKIE OR
97267-2148
US

IV. Provider business mailing address

6950 NE CAMPUS WAY
HILLSBORO OR
97124-5611
US

V. Phone/Fax

Practice location:
  • Phone: 503-659-0930
  • Fax: 503-654-3846
Mailing address:
  • Phone: 503-952-2167
  • Fax: 503-952-2267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD9149
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: