Individual
TAYLOR MARILYN JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1253 NW CANAL BLVD, REDMOND, OR 97756-1334
(541) 548-8131
(541) 460-4028
Mailing address
PO BOX 6096, BEND, OR 97708-6096
(541) 548-8131
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
175861
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50710
ARIZONA MEDICAL BOARD
AZ
Enumeration date
06/02/2013
Last updated
04/22/2020
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