| Doctor Name: | TARAN LORA ENGELBART |
| NPI Number: | 1043555709 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN, FNP-BC |
| License Number: | 209009690 |
| Business Practice Address: | 10414 Beardslee Blvd Ste 100 Bothell, WA - 980113205 |
| Business Phone Number: | 4254860658 |
| Business Fax Number: | 4254876761 |
| Mailing Address: | 20905 33rd Dr Se, BOTHELL |
| State: | WA |
| Postal Code: | 980213536 |
| Phone Number: | 7738966592 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2012 |
| NPI Last Update Date: | 11/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209009690 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |