Individual
STACEY ERIN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3322 BROADWAY, EVERETT, WA 98201-4425
(360) 996-4487
Mailing address
PO BOX 4384, TUMWATER, WA 98501-0384
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60458060
WA
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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