Provider Demographics
NPI:1760238836
Name:TAYLOR, ANNIE MACKENZIE (BSC, CPC, AAC)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:MACKENZIE
Last Name:TAYLOR
Suffix:
Gender:X
Credentials:BSC, CPC, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ASTOR ST APT 308
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2978
Mailing Address - Country:US
Mailing Address - Phone:360-303-0013
Mailing Address - Fax:
Practice Address - Street 1:192 E BAKERVIEW RD STE 102
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8179
Practice Address - Country:US
Practice Address - Phone:360-746-7282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61503595175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist