Provider Demographics
NPI:1285185892
Name:BORRELLI, JOSHUA (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:BORRELLI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18235 SW 135TH TER
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7321
Mailing Address - Country:US
Mailing Address - Phone:503-583-4118
Mailing Address - Fax:503-444-9018
Practice Address - Street 1:18235 SW 135TH TER
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7321
Practice Address - Country:US
Practice Address - Phone:503-583-4118
Practice Address - Fax:503-444-9018
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2762103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical