Provider Demographics
NPI:1366620239
Name:MCGUFFIN, GARY ROBIN (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:ROBIN
Last Name:MCGUFFIN
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 871542
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-1542
Mailing Address - Country:US
Mailing Address - Phone:360-892-7900
Mailing Address - Fax:360-892-7900
Practice Address - Street 1:10800 SE 17TH CIRCLE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-6219
Practice Address - Country:US
Practice Address - Phone:360-892-7900
Practice Address - Fax:360-892-7900
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1861103TC0700X
OR1137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical