Doctor Name: | DENNIS BORGMAN |
NPI Number: | 1144490863 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | RC00052222 |
Business Practice Address: | 425 E Main St Ste 600 Othello, WA - 993441146 |
Business Phone Number: | 5094884074 |
Business Fax Number: | 5094880166 |
Mailing Address: | 425 E Main St Ste 600, OTHELLO |
State: | WA |
Postal Code: | 993441146 |
Phone Number: | 5094884074 |
Fax Number: | 5094880166 |
NPI Enumeration Date: | 03/10/2008 |
NPI Last Update Date: | 03/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | RC00052222 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |