Healthcare Provider Details

I. General information

NPI: 1841224102
Provider Name (Legal Business Name): CYNTHIA TAYLOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16110 8TH AVE SW STE A3
BURIEN WA
98166-2962
US

IV. Provider business mailing address

16110 8TH AVE SW STE A3
BURIEN WA
98166-2962
US

V. Phone/Fax

Practice location:
  • Phone: 206-244-5520
  • Fax: 206-957-0034
Mailing address:
  • Phone: 206-244-5520
  • Fax: 206-957-0034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00025830
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: