Provider Demographics
NPI:1932322997
Name:DURKIN, ELIZABETH (OT, EAMP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:DURKIN
Suffix:
Gender:F
Credentials:OT, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 NW MARKET ST STE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5815
Mailing Address - Country:US
Mailing Address - Phone:206-706-0063
Mailing Address - Fax:206-508-1265
Practice Address - Street 1:2821 NW MARKET ST STE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5815
Practice Address - Country:US
Practice Address - Phone:206-706-0063
Practice Address - Fax:206-508-1265
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002083171100000X
WAOT60645141225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA20-1631890OtherTAX ID #