Provider Demographics
NPI:1720390438
Name:BOROUGHS, KAREN IRENE (DPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:IRENE
Last Name:BOROUGHS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1875
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-1875
Mailing Address - Country:US
Mailing Address - Phone:541-399-4308
Mailing Address - Fax:
Practice Address - Street 1:1630 WOODS CT
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2911
Practice Address - Country:US
Practice Address - Phone:541-387-6339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61170952225100000X
OR6065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6065OtherPHYSICAL THERAPY LICENSE