Individual
LILIAN RENATA BORNIO CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16463 BOONES FERRY RD STE 300, LAKE OSWEGO, OR 97035-4376
(503) 658-9351
(541) 708-5934
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
(503) 294-4321
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA211394
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
02/23/2021
Last updated
02/15/2024
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