Shinobu Tomaru Taylor

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

61254806 Issued in WA

Practice address

4320 196TH St SW Ste D
Lynnwood, WA 98036-6753

Phone

(425) 774-8758

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1629797774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20127 26TH DR SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980127601",
            "telephone_number": "425-503-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 196TH ST SW STE D",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366753",
            "telephone_number": "425-774-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SHINOBU",
        "middle_name": "TOMARU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "61254806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Scott Taylor
• Fletcher Brandon Taylor, M.D.
• Jacob Justin Taylor, MA, CP.
• Jeff Taylor, LMP
• Katherine Taylor, DDS
• Stephanie Taylor, DDS
• Vanessa Renee Taylor
• Biruke Tekelegiorgis
• Cynthia Tembula, PHARMACY TECHNICIAN
• Valery L Teran

• Physical Therapy Assistant in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.