Individual
DR. PETER JACK TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10202 SE 32ND AVE STE 701, MILWAUKIE, OR 97222-3625
(503) 513-1410
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
005971
AZ
2084P0800X
Psychiatry Physician
Primary
DO154273
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500645932
—
OR
Enumeration date
11/02/2007
Last updated
10/06/2020
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