Provider Demographics
NPI:1275652463
Name:NORTHWEST NEUROLOGY CAROLYN L. TAYLOR, M.D. PS
Entity Type:Organization
Organization Name:NORTHWEST NEUROLOGY CAROLYN L. TAYLOR, M.D. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-752-9919
Mailing Address - Street 1:11 BELLWETHER WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2957
Mailing Address - Country:US
Mailing Address - Phone:360-752-9919
Mailing Address - Fax:360-752-1647
Practice Address - Street 1:11 BELLWETHER WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2957
Practice Address - Country:US
Practice Address - Phone:360-752-9919
Practice Address - Fax:360-752-1647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA392452084N0400X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty