Individual
MARY L BORGSTADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
735 12TH ST SE, AUBURN, WA 98002-6709
(253) 876-7990
Mailing address
735 12TH ST SE, AUBURN, WA 98002-6709
(253) 876-7990
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
RN00157592
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30006913
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7235BO
INDIVIDUAL BLUE SHIED
WA
05
—
9645029
—
WA
01
—
P0026399
RAIL ROAD MEDICARE
WA
Enumeration date
02/03/2006
Last updated
05/06/2016
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