Individual
TAYLOR CLARK STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
PG221438
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG212546
NM
390200000X
Student in an Organized Health Care Education/Training Program
PG212546
OR
Other
Enumeration date
06/23/2022
Last updated
12/26/2024
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