Provider Demographics
NPI:1659554467
Name:OCCUPATIONAL PERFORMANCE CONSULTANTS
Entity Type:Organization
Organization Name:OCCUPATIONAL PERFORMANCE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:360-379-0705
Mailing Address - Street 1:1823 HOLCOMB ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-6021
Mailing Address - Country:US
Mailing Address - Phone:360-379-0705
Mailing Address - Fax:360-343-0540
Practice Address - Street 1:211 TAYLOR ST
Practice Address - Street 2:#3
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-5753
Practice Address - Country:US
Practice Address - Phone:360-379-0705
Practice Address - Fax:360-343-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT00002944OtherSTATE LICENSE