Provider Demographics
NPI:1811541170
Name:SMITH, TAYLOR S (CFY-SLP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:S
Other - Last Name:MARTINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13607 EAST SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-202-5260
Mailing Address - Fax:509-931-0780
Practice Address - Street 1:13607 EAST SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216
Practice Address - Country:US
Practice Address - Phone:509-202-5260
Practice Address - Fax:509-931-0780
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5I60966556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5I60966556OtherWASHINGTON STATE DEPT OF HEALTH