Healthcare Provider Details

I. General information

NPI: 1629993167
Provider Name (Legal Business Name): TAYLOR BUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 RAINIER AVE S STE 204
SEATTLE WA
98118-2445
US

IV. Provider business mailing address

5600 RAINIER AVE S STE 204
SEATTLE WA
98118-2445
US

V. Phone/Fax

Practice location:
  • Phone: 253-225-9960
  • Fax:
Mailing address:
  • Phone: 253-225-9960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70138225
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: