Provider Demographics
NPI:1578832390
Name:LUND, TAFFY JO (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAFFY
Middle Name:JO
Last Name:LUND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TAFFY
Other - Middle Name:JO
Other - Last Name:GENNARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2260 DIVISION ST NW APT 20B
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4279
Mailing Address - Country:US
Mailing Address - Phone:360-753-2634
Mailing Address - Fax:
Practice Address - Street 1:2260 DIVISION ST NW APT 20B
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4279
Practice Address - Country:US
Practice Address - Phone:360-753-2634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 60261423225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist