Individual
JASON DANIEL TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4503
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61778
STATE OF OREGON PHYSICAL THERAPIST LICENSING BOARD
OR
Enumeration date
08/05/2014
Last updated
03/03/2020
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