Provider Demographics
NPI:1912384934
Name:DUFFY, VARINA (COTA/L)
Entity Type:Individual
Prefix:
First Name:VARINA
Middle Name:
Last Name:DUFFY
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-8809
Mailing Address - Country:US
Mailing Address - Phone:253-886-4184
Mailing Address - Fax:
Practice Address - Street 1:604 10TH AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-8809
Practice Address - Country:US
Practice Address - Phone:253-886-4184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60344538225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist