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LILIAN RENATA BORNIO CARRILLO

Individual Provider (NPI-1) Active

Physician Assistant

Provider Information

NPI Number
1275127979
Provider Type
Individual Provider (NPI-1)
Status
Active

Contact & Location

Address
16463 BOONES FERRY RD STE 300, LAKE OSWEGO, OR, 970354376
Phone
(503) 658-9351
Fax
(541) 708-5934

Specialties & Taxonomies

Physician Assistant Primary License: OR #PA211394
Student in an Organized Health Care Education/Training Program License: OR

All Addresses

LOCATION

16463 BOONES FERRY RD STE 300

LAKE OSWEGO, OR, 970354376

(503) 658-9351

MAILING

232 NW 6TH AVE

PORTLAND, OR, 972093609

(503) 294-1681