Healthcare Provider Details

I. General information

NPI: 1023912672
Provider Name (Legal Business Name): MATTHEW BRUCE DUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 NE GILMAN BLVD STE 100
ISSAQUAH WA
98027-2940
US

IV. Provider business mailing address

10908 57TH AVENUE CT E
PUYALLUP WA
98373-5716
US

V. Phone/Fax

Practice location:
  • Phone: 425-295-7697
  • Fax:
Mailing address:
  • Phone: 425-281-9760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: