Provider Demographics
NPI:1851875942
Name:SKELTON, TAYLOR (DPT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:SKELTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1896 DEER HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:MN
Mailing Address - Zip Code:55731-8016
Mailing Address - Country:US
Mailing Address - Phone:218-235-3770
Mailing Address - Fax:
Practice Address - Street 1:140 SW 146TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1912
Practice Address - Country:US
Practice Address - Phone:206-630-3000
Practice Address - Fax:844-660-0682
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist