Provider Demographics
NPI:1851056543
Name:TONOZZI, WILLOW HAGAN (OTD)
Entity type:Individual
Prefix:
First Name:WILLOW
Middle Name:HAGAN
Last Name:TONOZZI
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:WILLOW
Other - Middle Name:MICHELE
Other - Last Name:HAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8937
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-8937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2901 FALK RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-6392
Practice Address - Country:US
Practice Address - Phone:360-313-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT.OT.70012714225X00000X
OR461920225X00000X
COOT.00070898225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist