Provider Demographics
NPI:1780938514
Name:TAYLOR, DAVID CARL (MS PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CARL
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12837 NE 140TH CT
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1500
Mailing Address - Country:US
Mailing Address - Phone:425-820-8596
Mailing Address - Fax:
Practice Address - Street 1:12837 NE 140TH CT
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-1500
Practice Address - Country:US
Practice Address - Phone:425-820-8596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00001039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00001039OtherWASHINGTON STATE LICENSE