MEDICARE: MARLY GENEVIEVE GAFFNEY DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT61077740	WA
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1427669571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLY GENEVIEVE GAFFNEY DPT

Provider Business Mailing Address
First Line	:	25117 SW PARKWAY AVE STE D
Second Line	:
City	:	WILSONVILLE
State	:	OR
Zip	:	97070-9697
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 PHINNEY AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-6399
Country	:	US
Telephone Number	:	206-632-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2020
Last Update Date	:	03/21/2024

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