Individual
DR. RONALD TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
24076 SE STARK ST STE 210, GRESHAM, OR 97030-3376
(503) 419-1666
Mailing address
24076 SE STARK ST STE 210, GRESHAM, OR 97030-3376
(503) 491-1667
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
419597
OR
225XH1200X
Hand Occupational Therapist
419597
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
419597
OCCUPATIONAL THERAPY LICENSE
OR
Enumeration date
06/21/2019
Last updated
06/21/2019
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