Provider Demographics
NPI:1285401851
Name:TAYLOR, CARINA (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:CARINA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:MS
Other - First Name:CARINA
Other - Middle Name:
Other - Last Name:BYNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:400 S 43RD ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5714
Mailing Address - Country:US
Mailing Address - Phone:425-690-1000
Mailing Address - Fax:
Practice Address - Street 1:400 S 43RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5714
Practice Address - Country:US
Practice Address - Phone:425-690-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60894124133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered