Individual
MR. BRENT TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2347 E GALA ST, MERIDIAN, ID 83642-4881
(208) 706-6718
Mailing address
4311 11TH AVENUE NE, SUITE 200, MEDEX NORTHWEST, SEATTLE, WA 98105
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1578
ID
Other
Enumeration date
06/01/2016
Last updated
03/28/2018
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