Healthcare Provider Details

I. General information

NPI: 1689507626
Provider Name (Legal Business Name): TAYLOR ELIZABETH VINCENT LSWAIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 5TH AVE
SEATTLE WA
98104-1818
US

IV. Provider business mailing address

401 5TH AVE
SEATTLE WA
98104-1818
US

V. Phone/Fax

Practice location:
  • Phone: 270-438-9654
  • Fax:
Mailing address:
  • Phone: 270-438-9654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWIA.SC.70016992
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: