Provider Demographics
NPI:1619042280
Name:DUFFY, ERIN M (OTR L)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:M
Last Name:DUFFY
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 S UNION AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1953
Mailing Address - Country:US
Mailing Address - Phone:253-678-9218
Mailing Address - Fax:253-314-5813
Practice Address - Street 1:1818 S UNION AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1953
Practice Address - Country:US
Practice Address - Phone:253-678-9218
Practice Address - Fax:253-314-5813
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001534225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA128756OtherLABOR AND INDUSTRIES WC
WADU5714OtherREGENCE BCBS
WA670002062OtherRR MEDICARE
WA8369324Medicaid
WAGAB21986Medicare PIN