Provider Demographics
NPI:1972123776
Name:DUVIL, ANDREA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:DUVIL
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 1:510 STEVENS AVE SW APT Q205
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2374
Mailing Address - Country:US
Mailing Address - Phone:425-269-6377
Mailing Address - Fax:
Practice Address - Street 1:24121 116TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-5379
Practice Address - Country:US
Practice Address - Phone:425-269-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60743092225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist