Provider Demographics
NPI:1932124773
Name:TAGGART, LORI ANNE (ARNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:TAGGART
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28371 23RD AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-2967
Mailing Address - Country:US
Mailing Address - Phone:253-941-6900
Mailing Address - Fax:206-246-2421
Practice Address - Street 1:16122 8TH AVE SW
Practice Address - Street 2:SUITE E-1
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2967
Practice Address - Country:US
Practice Address - Phone:206-246-2291
Practice Address - Fax:206-246-2421
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003281363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP30003281OtherSTATE LICENSE
WAS45081Medicare UPIN