1083648877 NPI number — CYNTHIA L. TAYLOR, MD

Table of content: (NPI 1083648877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083648877 NPI number — CYNTHIA L. TAYLOR, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CYNTHIA L. TAYLOR, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WHOLE FAMILY HEALTH CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083648877
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6989
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97228-6989
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-439-4888
Provider Business Mailing Address Fax Number:
206-242-7247

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14212 AMBAUM BLVD SW
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
BURIEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98166-1449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-244-5520
Provider Business Practice Location Address Fax Number:
206-957-0034
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
206-244-5520

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  WA00025830 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2300X , with the licence number: 00025830 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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