Provider Demographics
NPI:1114432960
Name:BOROWSKI-RISKEDAHL, RUTH ANNE X (BS CADC I, CGAC I)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANNE
Last Name:BOROWSKI-RISKEDAHL
Suffix:X
Gender:F
Credentials:BS CADC I, CGAC I
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:ANNE
Other - Last Name:BOROWSKI-RISKEDAHL
Other - Suffix:X
Other - Last Name Type:Professional Name
Other - Credentials:BS CADC I, CGAC I,
Mailing Address - Street 1:29500 SW MONTEBELLO DR
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-7577
Mailing Address - Country:US
Mailing Address - Phone:503-975-0828
Mailing Address - Fax:
Practice Address - Street 1:504 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1852
Practice Address - Country:US
Practice Address - Phone:503-245-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14-07-17U101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty