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General NPI Number Information
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NPI Number | 1760405310
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Entity Type | Individual
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Provider Name | MICHELLE DIONE TAYLOR MD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 2101 NE 139TH STREET MOB B SUITE 260
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City | VANCOUVER
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State | WA
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Zip | 98686-2742
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Country | US
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Telephone | 360-487-2810
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 NE 139TH ST #260
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City | VANCOUVER
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State | WA
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Zip | 98686-2309
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD00046752
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License Number State | WA
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