Provider Demographics
NPI:1861469629
Name:MCDUFF, TOBAE G (MD)
Entity Type:Individual
Prefix:
First Name:TOBAE
Middle Name:G
Last Name:MCDUFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 RUCKER AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2723
Mailing Address - Country:US
Mailing Address - Phone:425-259-5121
Mailing Address - Fax:425-252-2189
Practice Address - Street 1:2326 RUCKER AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2723
Practice Address - Country:US
Practice Address - Phone:425-259-5121
Practice Address - Fax:425-252-2189
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000183302084N0400X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1107002Medicaid
WA1107002Medicaid
WAG115000609Medicare PIN