Healthcare Provider Details

I. General information

NPI: 1376148783
Provider Name (Legal Business Name): STEPHANIE MARIE BORJAS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3339 SE DIVISION ST STE C
PORTLAND OR
97202-1497
US

IV. Provider business mailing address

7007 SW 4TH AVE
PORTLAND OR
97219-2218
US

V. Phone/Fax

Practice location:
  • Phone: 971-333-0603
  • Fax:
Mailing address:
  • Phone: 512-810-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number202201773NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: