MEDICARE: TERRA TAYLOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	BAP-E-10264979	OR

General Provider Information

NPI Number	:	1437008893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRA TAYLOR

Provider Business Mailing Address
First Line	:	7405 SW TECH CENTER DR STE 100
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8056
Country	:	US
Telephone Number	:	503-734-7764
Fax Number	:

Provider Business Practice Location Address
First Line	:	7405 SW TECH CENTER DR STE 100
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8056
Country	:	US
Telephone Number	:	503-734-7764
Fax Number	:	503-296-2657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “ TERRA TAYLOR ” Practice Location

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