Provider Demographics
NPI:1871606814
Name:DUFF, MARILYN GAY (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:GAY
Last Name:DUFF
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2834 CALAIS LN NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-3928
Mailing Address - Country:US
Mailing Address - Phone:253-583-1648
Mailing Address - Fax:
Practice Address - Street 1:9600 VETERANS DR SW
Practice Address - Street 2:POC , BLDG 61C
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-5000
Practice Address - Country:US
Practice Address - Phone:253-583-1648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000078881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical