Laurie Midori Tazuma, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD00018588 Issued in WA

Practice address

4020 E Madison St
Suite 240
Seattle, WA 98112-3149

Phone

(206) 322-0391

Fax

(206) 323-2077

NPI assigned

Jan 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 6, 2016 through Jan 6, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366594483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 E MADISON ST",
            "address_2": "SUITE 240",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981123149",
            "telephone_number": "206-322-0391",
            "fax_number": "206-323-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 E MADISON ST",
            "address_2": "SUITE 240",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981123149",
            "telephone_number": "206-322-0391",
            "fax_number": "206-323-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAZUMA",
        "first_name": "LAURIE",
        "middle_name": "MIDORI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00018588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "0157499",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982808",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susannah I Taylor, M.D.
• Taisha Taylor
• Tod Alan Taylor, LMP
• Tracy Lynn Taylor, MS CN
• Ralph Shamekh Tayyar, MD
• TCC Inc PS (The Chiropractic Centre)
• Misghana Genrehiwo Teages I, RN
• Candice Teague, NP
• Team Vocational Services
• Siale Teaupa, MD, MPH

• Psychiatry Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.