Individual
TAYLOR THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
1233 EDGEWATER ST NW, SALEM, OR 97304-4049
(503) 378-7526
Mailing address
190 KINGWOOD AVE NW, SALEM, OR 97304-4030
(503) 378-7526
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000003906
OR
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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