Healthcare Provider Details

I. General information

NPI: 1427649060
Provider Name (Legal Business Name): CORY ANN DUFFIELD BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 NE 50TH ST
SEATTLE WA
98105-4824
US

IV. Provider business mailing address

116 NE 50TH ST
SEATTLE WA
98105-4824
US

V. Phone/Fax

Practice location:
  • Phone: 701-205-9018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSYCH.PY.70090558
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: