Provider Demographics
NPI:1144242454
Name:TAYLOR, ROBERT ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:ALAN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1701 CAMDEN PARK DR SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-5506
Mailing Address - Country:US
Mailing Address - Phone:360-943-5448
Mailing Address - Fax:
Practice Address - Street 1:1701 CAMDEN PARK DR SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98512-5506
Practice Address - Country:US
Practice Address - Phone:360-943-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP000855207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine