Provider Demographics
NPI:1528627924
Name:BOZARTH, TAYLOR (CNTP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BOZARTH
Suffix:
Gender:F
Credentials:CNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 20TH AVE E
Mailing Address - Street 2:APT B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5370
Mailing Address - Country:US
Mailing Address - Phone:805-804-7829
Mailing Address - Fax:
Practice Address - Street 1:120 20TH AVE E
Practice Address - Street 2:APT B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5370
Practice Address - Country:US
Practice Address - Phone:805-804-7829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education