Individual
STACEY TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9205 SW BARNES RD, PROVIDENCE CHILDREN'S DEVELOPMENT INSTITUTE, PORTLAND, OR 97225-6603
(503) 216-8019
Mailing address
9205 SW BARNES RD, PROVIDENCE CHILDREN'S DEVELOPMENT INSTITUTE, PORTLAND, OR 97225-6603
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
342970
OR
Other
Enumeration date
08/23/2016
Last updated
07/21/2021
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