Provider Demographics
NPI:1780432336
Name:BORJAS, MIKAELA JAYD
Entity type:Individual
Prefix:MRS
First Name:MIKAELA
Middle Name:JAYD
Last Name:BORJAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 NW 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3402
Mailing Address - Country:US
Mailing Address - Phone:541-901-2039
Mailing Address - Fax:
Practice Address - Street 1:342 NW 22ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3402
Practice Address - Country:US
Practice Address - Phone:541-901-2039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health