Provider Demographics
NPI:1609277730
Name:TAYLOR, KARYL (LMP)
Entity Type:Individual
Prefix:
First Name:KARYL
Middle Name:
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 1:1059 STATE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4269
Mailing Address - Country:US
Mailing Address - Phone:360-318-3476
Mailing Address - Fax:
Practice Address - Street 1:1059 STATE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4269
Practice Address - Country:US
Practice Address - Phone:360-618-3476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60475800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist