Healthcare Provider Details

I. General information

NPI: 1720383896
Provider Name (Legal Business Name): MICHAEL ALLEN TAYLOR PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 N ASSEMBLY ST
SPOKANE WA
99205-6185
US

IV. Provider business mailing address

4915 S REGAL ST
SPOKANE WA
99223-7633
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-7022
  • Fax:
Mailing address:
  • Phone: 509-822-3275
  • Fax: 509-822-3285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6317
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1958
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60827712
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH60827712
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: