Healthcare Provider Details

I. General information

NPI: 1134379811
Provider Name (Legal Business Name): LORI D TAYLOR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORI D POWELL RN

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W 7TH AVE 450
SPOKANE WA
99204-2349
US

IV. Provider business mailing address

122 W 7TH AVE 450
SPOKANE WA
99204-2349
US

V. Phone/Fax

Practice location:
  • Phone: 509-455-8820
  • Fax: 509-838-4978
Mailing address:
  • Phone: 509-455-8820
  • Fax: 509-838-4978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60053061
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00091351
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: