Provider Demographics
NPI:1104664788
Name:BORQUIST, KRISTEN LEA (MS, LMHC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEA
Last Name:BORQUIST
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 GUSTAFSON DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8155
Mailing Address - Country:US
Mailing Address - Phone:253-222-1333
Mailing Address - Fax:833-672-3313
Practice Address - Street 1:5800 SOUNDVIEW DR BLDG B
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2000
Practice Address - Country:US
Practice Address - Phone:253-256-2009
Practice Address - Fax:833-672-3313
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61549706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health