Provider Demographics
NPI:1427139583
Name:TAYLOR, JOSEPH STERLING (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:STERLING
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 E MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-8964
Mailing Address - Country:US
Mailing Address - Phone:509-935-6001
Mailing Address - Fax:509-935-4196
Practice Address - Street 1:208 CEDAR CREEK TERRACE
Practice Address - Street 2:BOX 197
Practice Address - City:IONE
Practice Address - State:WA
Practice Address - Zip Code:99139
Practice Address - Country:US
Practice Address - Phone:509-442-3514
Practice Address - Fax:509-442-3436
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA163907OtherLABOR & INDUSTRIES ID #
WA8317489Medicaid
WA163907OtherLABOR & INDUSTRIES ID #
WA8317489Medicaid
WAAB33057Medicare ID - Type UnspecifiedMEDICARE PART B ID NUMBER
WAAB33060Medicare ID - Type UnspecifiedMEDICARE PART B ID NUMBER
WAAB033058Medicare ID - Type UnspecifiedMEDICARE PART B ID NUMBER
WAAB33055Medicare ID - Type UnspecifiedMEDICARE PART B ID NUMBER
WAAB33059Medicare ID - Type UnspecifiedMEDICARE PART B ID NUMBER