Provider Demographics
NPI:1598835134
Name:BORCHERS, ALICIA ROSE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:ROSE
Last Name:BORCHERS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 WEIGEL AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660
Mailing Address - Country:US
Mailing Address - Phone:360-607-4115
Mailing Address - Fax:
Practice Address - Street 1:7301 NE HWY 99
Practice Address - Street 2:STE 7
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665
Practice Address - Country:US
Practice Address - Phone:360-573-4666
Practice Address - Fax:360-573-4668
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022079225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist