Individual provider Active NPI

Earl Finley Taylor, PAC

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1063484962
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10002700 Issued in WA
Practice address
212 E Central Ave Ste 440
Spokane, WA 99208-6290
Phone
(509) 252-9602
Fax
(509) 227-7070
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10002700 WA Primary

Addresses

Primary practice location

212 E Central Ave Ste 440
Spokane, WA 99208-6290

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 2

IdentifierTypeStateIssuer
127188OtherWALABOR & INDUSTRIES
8371338MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address etaylor214361@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803000319 WA Practitioner - Physician Assistant 2062483217 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10002700WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Dec 1, 2015 Accepting new patients
Providence Health & Services Washington CurrentSince Dec 1, 2015 Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880

105 W 8th Ave
Ste 6045
Spokane, WA 99204
Phone (509) 455-3676

212 E Central Ave
Ste 440
Spokane, WA 99208
Phone (509) 252-1977

Interoperability endpoints

  • Direct secure messaging: etaylor214361@wm.providencedirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1063484962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E CENTRAL AVE STE 440",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086290",
            "telephone_number": "509-252-9602",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "EARL",
        "middle_name": "FINLEY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10002700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "127188",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8371338",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "etaylor214361@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "212 E Central Ave Ste 440",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992086290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.