Provider Demographics
NPI:1508384694
Name:BORCHARDT, TRESSA (LMHCA)
Entity Type:Individual
Prefix:
First Name:TRESSA
Middle Name:
Last Name:BORCHARDT
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 152ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1723
Mailing Address - Country:US
Mailing Address - Phone:402-890-5580
Mailing Address - Fax:
Practice Address - Street 1:24909 104TH AVE SE STE 101A
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-2819
Practice Address - Country:US
Practice Address - Phone:206-388-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60789512101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health