Individual
TRAVIS JOHNATHAN TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3400 STATE ST STE G770, SALEM, OR 97301-7014
(503) 585-6700
(503) 585-3315
Mailing address
2859 EAGLE EYE AVE NW, SALEM, OR 97304-4366
(503) 949-5050
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3452ATI
OR
332H00000X
Eyewear Supplier
3452ATI
OR
Other
Enumeration date
06/23/2008
Last updated
07/08/2021
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