Provider Demographics
NPI:1891036935
Name:DODD, TAYLOR NICOLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:NICOLE
Last Name:DODD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:TAYLOR
Other - Middle Name:NICOLE
Other - Last Name:SANDWITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:16404 SMOKEY POINT BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223
Mailing Address - Country:US
Mailing Address - Phone:360-653-0950
Mailing Address - Fax:360-653-9887
Practice Address - Street 1:16404 SMOKEY POINT BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:360-653-0950
Practice Address - Fax:360-653-9887
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60324966225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist