Provider Demographics
NPI:1932844362
Name:BORG, WENDY-LYNNE MARIE
Entity type:Individual
Prefix:
First Name:WENDY-LYNNE
Middle Name:MARIE
Last Name:BORG
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 1:2511 104TH ST E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-5311
Mailing Address - Country:US
Mailing Address - Phone:253-592-2375
Mailing Address - Fax:
Practice Address - Street 1:600 STEWART ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1257
Practice Address - Country:US
Practice Address - Phone:253-592-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician