Healthcare Provider Details

I. General information

NPI: 1144185836
Provider Name (Legal Business Name): BROOK TAYE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 SW 8TH ST
BATTLE GROUND WA
98604-3098
US

IV. Provider business mailing address

307 SW 8TH ST
BATTLE GROUND WA
98604-3098
US

V. Phone/Fax

Practice location:
  • Phone: 425-529-3315
  • Fax: 360-723-0029
Mailing address:
  • Phone: 425-529-3315
  • Fax: 360-723-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number758645
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: