Provider Demographics
NPI:1134242555
Name:TAYLOR, REBECCA DENISE (LMP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:DENISE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:33450 37TH PL SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2957
Mailing Address - Country:US
Mailing Address - Phone:253-531-1000
Mailing Address - Fax:253-531-0967
Practice Address - Street 1:8833 PACIFIC AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-6490
Practice Address - Country:US
Practice Address - Phone:253-531-1000
Practice Address - Fax:253-531-0967
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016636225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist