Provider Demographics
NPI:1114189685
Name:TAYLOR, LEAH MARIE (LMP)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 32ND ST
Mailing Address - Street 2:#205
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6925
Mailing Address - Country:US
Mailing Address - Phone:360-303-3250
Mailing Address - Fax:360-676-5977
Practice Address - Street 1:1215 MILL AVE
Practice Address - Street 2:STE A
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7147
Practice Address - Country:US
Practice Address - Phone:360-647-1970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist