Provider Demographics
NPI:1083816995
Name:BANAY, CAMILLE (OT)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:BANAY
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:
Other - Last Name:BANAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:2219 RIMLAND DR STE 301
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8759
Mailing Address - Country:US
Mailing Address - Phone:865-352-4077
Mailing Address - Fax:
Practice Address - Street 1:2219 RIMLAND DR STE 301
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8759
Practice Address - Country:US
Practice Address - Phone:865-352-4077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
TN6617225X00000X
WA61570199225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist