Individual
DAVID TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3871 FAIRVIEW INDUSTRIAL DR SE STE 150, SALEM, OR 97302-1172
(503) 391-9762
(503) 315-2019
Mailing address
3871 FAIRVIEW INDUSTRIAL DR SE STE 150, SALEM, OR 97302-1172
(503) 391-9762
(503) 315-2019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427508571
—
OR
Enumeration date
10/12/2016
Last updated
10/17/2016
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