Individual
TAYLOR NICOLE WORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
890 OAK ST SE, SALEM, OR 97301-3905
(503) 561-5200
Mailing address
2775 SW TROY ST, PORTLAND, OR 97219-2552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/29/2024
Last updated
08/27/2024
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