Healthcare Provider Details

I. General information

NPI: 1144327230
Provider Name (Legal Business Name): PATRICK E TAYLOR DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 116TH AVE NE SUITE 202
BELLEVUE WA
98004
US

IV. Provider business mailing address

1800 116TH AVE NE SUITE 202
BELLEVUE WA
98004
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-4858
  • Fax: 425-646-0817
Mailing address:
  • Phone: 425-454-4858
  • Fax: 425-646-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number8068
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: