Provider Demographics
NPI:1710472840
Name:COLE TAYLOR, JUNIPER DELILAH (LM)
Entity Type:Individual
Prefix:
First Name:JUNIPER
Middle Name:DELILAH
Last Name:COLE TAYLOR
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-9514
Mailing Address - Country:US
Mailing Address - Phone:360-389-1896
Mailing Address - Fax:
Practice Address - Street 1:465 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-9514
Practice Address - Country:US
Practice Address - Phone:360-389-1896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-01
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW00000255176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife