Provider Demographics
NPI:1356895965
Name:MAYERS, TAYLOR ANN (LMP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:MAYERS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 3RD ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-5007
Mailing Address - Country:US
Mailing Address - Phone:425-923-7505
Mailing Address - Fax:
Practice Address - Street 1:1821 3RD ST UNIT B
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-5007
Practice Address - Country:US
Practice Address - Phone:425-923-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60680125225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist