Individual
MICHAEL BORGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2014 NW GLISAN ST, 511, PORTLAND, OR 97209-1163
(971) 570-5829
Mailing address
2014 NW GLISAN ST, 511, PORTLAND, OR 97209-1163
(971) 570-5829
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9068
OR
Other
Enumeration date
12/14/2009
Last updated
12/14/2009
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