MEDICARE: TAYLOR LORRAINE MUENCHOW PA-C

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
1	363A00000X	Physician Assistant	PA61218852	WA

General Provider Information

NPI Number	:	1629672530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR LORRAINE MUENCHOW PA-C

Provider Business Mailing Address
First Line	:	1620 COOPER POINT RD SW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-5736
Country	:	US
Telephone Number	:	360-486-6710
Fax Number	:	360-705-0269

Provider Business Practice Location Address
First Line	:	1620 COOPER POINT RD SW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-5736
Country	:	US
Telephone Number	:	360-486-6710
Fax Number	:	360-705-0269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	12/16/2025

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