Provider Demographics
NPI:1235281544
Name:TAYLOR, CHRISTINE SIMONE (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SIMONE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 NE 128TH ST STE 510
Mailing Address - Street 2:MTI PHYSICAL THERAPY
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7296
Mailing Address - Country:US
Mailing Address - Phone:425-820-2590
Mailing Address - Fax:
Practice Address - Street 1:1540 140TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-4516
Practice Address - Country:US
Practice Address - Phone:425-644-6048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist