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General NPI Number Information
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NPI Number | 1902199128
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Entity Type | Individual
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Provider Name | DOUGLAS CARPENTER TAYLOR L.M.P.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 7406 27TH ST W STE 23
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4637
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Country | US
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Telephone | 253-498-0305
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Fax | 253-752-4250
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Provider Business Mailing Address
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Address Line | PO BOX 6900
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City | TACOMA
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State | WA
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Zip | 98417-0386
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Country | US
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Telephone | 253-468-0305
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Fax | 253-752-4250
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60213376
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License Number State | WA
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