Provider Demographics
NPI:1316250798
Name:TAYLOR, CHRISTOPHER SHANNON (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SHANNON
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16046 BEACH DR NE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-6740
Mailing Address - Country:US
Mailing Address - Phone:425-227-2301
Mailing Address - Fax:425-227-1300
Practice Address - Street 1:16046 BEACH DR NE
Practice Address - Street 2:
Practice Address - City:LAKE FOREST PARK
Practice Address - State:WA
Practice Address - Zip Code:98155-6740
Practice Address - Country:US
Practice Address - Phone:425-227-2301
Practice Address - Fax:425-227-1300
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00017862251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management