Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | 2254 | OR |
Y | 111NN0400X | Neurology | CH00002076 | WA |
NPI | 1164549135 |
---|---|
Provider Name | Dr. Mary K Taggart |
First Address | Seattle, WA 98125-7452 |
Second Address | Seattle, WA 98125-7452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 04/10/2012 |