Provider Demographics
NPI:1013883073
Name:BORDERS, CHARLENE S
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:S
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 1:22810 30TH AVE S UNIT B203
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-7298
Mailing Address - Country:US
Mailing Address - Phone:206-572-5771
Mailing Address - Fax:206-237-5894
Practice Address - Street 1:25432 33RD PL S UNIT B203
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5642
Practice Address - Country:US
Practice Address - Phone:206-572-5771
Practice Address - Fax:206-237-5894
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator