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NPI Code Detail

MEDICARE: JIL MARIE TAYLOR LMSW

MEDICARE: JIL MARIE TAYLOR LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorRC0005858564WA
2104100000XSocial WorkerLMSW-28303ID

General Provider Information

NPI Number : 1437349107
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIL MARIE TAYLOR LMSW
Provider Business Mailing Address
First Line : 629 6TH ST
Second Line :
City : CLARKSTON
State : WA
Zip : 99403-2010
Country : US
Telephone Number : 509-758-9698
Fax Number : 509-758-9664
Provider Business Practice Location Address
First Line : 629 6TH ST
Second Line :
City : CLARKSTON
State : WA
Zip : 99403-2010
Country : US
Telephone Number : 509-758-9698
Fax Number : 509-758-9664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2007
Last Update Date : 10/27/2007

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Directions to “ JIL MARIE TAYLOR LMSW” Practice Location

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