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Individual

EDWARD TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.C.

Contact information

Practice address
920 SW RANGE DR, WALDPORT, OR 97394-9634
(541) 563-3197
Mailing address
PO BOX 2847, CORVALLIS, OR 97339-2847

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01115
OR
363AM0700X
Medical Physician Assistant
PA10004205
WA

Other

Enumeration date
07/13/2006
Last updated
02/16/2021
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