Provider Demographics
NPI:1265801948
Name:BORKOWSKI, LAUREN (LMP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BORKOWSKI
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 1:2230 CORNERSTONE LN
Mailing Address - Street 2:APT 416
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-6001
Mailing Address - Country:US
Mailing Address - Phone:970-985-9329
Mailing Address - Fax:
Practice Address - Street 1:8862 BENDER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-8800
Practice Address - Country:US
Practice Address - Phone:360-354-1115
Practice Address - Fax:360-354-0321
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60595358225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist