MEDICARE: KATHLEEN BORDEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	L11753	OR
2	1041C0700X	Clinical Social Worker	CSW.09932433	CO
3	101YM0800X	Mental Health Counselor	CG60497216	WA

General Provider Information

NPI Number	:	1508313503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN BORDEN LCSW

Provider Business Mailing Address
First Line	:	3015 SW SALMON AVE
Second Line	:
City	:	REDMOND
State	:	OR
Zip	:	97756-8004
Country	:	US
Telephone Number	:	425-761-5863
Fax Number	:

Provider Business Practice Location Address
First Line	:	272 NW MEDICAL LOOP STE E
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97471-5545
Country	:	US
Telephone Number	:	541-900-4285
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2016
Last Update Date	:	02/23/2026

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Directions to “ KATHLEEN BORDEN LCSW” Practice Location

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