Provider Demographics
NPI:1275274698
Name:PASTOR, MICHAEL JORDAN BORJA (DNP, ARNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHAEL JORDAN
Middle Name:BORJA
Last Name:PASTOR
Suffix:
Gender:M
Credentials:DNP, ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 COLBY AVE STE 718
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3564
Mailing Address - Country:US
Mailing Address - Phone:425-339-5413
Mailing Address - Fax:
Practice Address - Street 1:2707 COLBY AVE STE 718
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3564
Practice Address - Country:US
Practice Address - Phone:425-339-5413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61300534363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily