Individual
DR. KEVIN W TAGGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 31ST AVE SW, STE. C, PUYALLUP, WA 98373-3723
(253) 848-5951
(253) 845-7073
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 845-7073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00036453
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128732
LABOR AND INDUSTRIES
WA
01
—
5920661
AETNA
WA
05
—
8240970
—
WA
01
—
8937586
L&I CRIME
WA
01
—
930079954
MEDICARE RAILROAD
WA
01
—
TA6989
REGENCE RIDER
WA
Enumeration date
12/18/2006
Last updated
01/25/2016
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