Provider Demographics
NPI:1184254062
Name:TAYLOR, CHRISTY (LAC)
Entity type:Individual
Prefix:MISS
First Name:CHRISTY
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4783 SW HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-1564
Mailing Address - Country:US
Mailing Address - Phone:808-652-0280
Mailing Address - Fax:
Practice Address - Street 1:4783 SW HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-1564
Practice Address - Country:US
Practice Address - Phone:808-652-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1291171100000X
ORAC216578171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist