Healthcare Provider Details

I. General information

NPI: 1164538062
Provider Name (Legal Business Name): DUFFY I, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 AMBAUM BLVD SW
BURIEN WA
98146-2651
US

IV. Provider business mailing address

12101 AMBAUM BLVD SW
SEATTLE WA
98146
US

V. Phone/Fax

Practice location:
  • Phone: 206-244-8100
  • Fax: 206-431-9142
Mailing address:
  • Phone: 206-244-8100
  • Fax: 206-431-9142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberAH-002
License Number StateWA

VIII. Authorized Official

Name: MS. JUNE ELAINE OKSENDAHL
Title or Position: ADMINISTRATOR
Credential:
Phone: 206-244-8100