Individual
WAYNE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, LMT
Contact information
Practice address
7839 SE 120TH PL, PORTLAND, OR 97266-5078
(503) 730-4082
Mailing address
7839 SE 120TH PL, PORTLAND, OR 97266-5078
(503) 730-4082
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8323
OR
225700000X
Massage Therapist
6629
OR
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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