Provider Demographics
NPI:1972958577
Name:BORDERS, ROXANNE MARIE
Entity Type:Individual
Prefix:MISS
First Name:ROXANNE
Middle Name:MARIE
Last Name:BORDERS
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 1:253 FERNDALE AVE NE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-5810
Mailing Address - Country:US
Mailing Address - Phone:425-269-6010
Mailing Address - Fax:
Practice Address - Street 1:253 FERNDALE AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-5810
Practice Address - Country:US
Practice Address - Phone:425-269-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst