Provider Demographics
NPI:1780740142
Name:TAGGART, MICHAEL C (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:TAGGART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11656 98TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-821-1101
Mailing Address - Fax:425-820-4988
Practice Address - Street 1:11656 98TH AVE NE
Practice Address - Street 2:STE B
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4216
Practice Address - Country:US
Practice Address - Phone:425-821-1101
Practice Address - Fax:425-820-4988
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002675111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG000105318Medicare PIN
WA602260256Medicare UPIN