Individual
COLBY JACK TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1900 NE 162ND AVE STE B101, VANCOUVER, WA 98684-3019
(503) 686-4110
Mailing address
3309 N MISSISSIPPI AVE APT 439, PORTLAND, OR 97227-2067
(503) 936-4450
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT.61271305
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT.61271305
WASHINGTON STATE HEALTH DEPARTMENT
WA
Enumeration date
05/24/2022
Last updated
05/24/2022
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