Individual
MARK SHANNON TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAC
Contact information
Practice address
1960 THOMPSON DR, SEDRO WOOLLEY, WA 98284-5007
(360) 856-3174
Mailing address
7440 W MARGINAL WAY S, SEATTLE, WA 98108-4141
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
CAAR.CG.60943113
WA
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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