Healthcare Provider Details

I. General information

NPI: 1225956220
Provider Name (Legal Business Name): FELIX BOR BSN,RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040A JACKSON AVE
JOINT BASE LEWIS MCCHORD WA
98431-0001
US

IV. Provider business mailing address

2211 LAKEWOOD DR SE
OLYMPIA WA
98501-3076
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1110
  • Fax:
Mailing address:
  • Phone: 605-519-0240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: