Individual
STEFANIE J BORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
24076 SE STARK ST, SUITE 200, GRESHAM, OR 97030-3373
(503) 491-1666
(503) 491-1667
Mailing address
765 SE MOUNT HOOD HWY, #J271, GRESHAM, OR 97080-7131
(503) 666-6549
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1001505
OR
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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