Individual
TAYLOR JAY DELAMARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1200 NW 23RD AVE, PORTLAND, OR 97210-2906
(503) 413-7074
(503) 413-6892
Mailing address
1200 NW 23RD AVE, PORTLAND, OR 97210
(503) 413-7074
(503) 413-6892
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
PG182916
OR
208600000X
Surgery Physician
PG178008
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2015
Last updated
07/21/2022
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