Provider Demographics
NPI:1841313947
Name:REED, TAYLOR JOYCE (LMP)
Entity type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:JOYCE
Last Name:REED
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:LOUISE
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23204 104TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031
Mailing Address - Country:US
Mailing Address - Phone:253-852-4826
Mailing Address - Fax:
Practice Address - Street 1:23204 104TH AVE SE
Practice Address - Street 2:PHILLIP A THOMPSON DC
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002
Practice Address - Country:US
Practice Address - Phone:253-939-0906
Practice Address - Fax:253-939-3381
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005207225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE0107Medicare UPIN