Healthcare Provider Details

I. General information

NPI: 1154518884
Provider Name (Legal Business Name): ERIN LEIGH TAYLOR OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 SE INTERNATIONAL WAY SUITE 100 CONSONUS HEALTHCARE SERVICES
MILWAUKIE OR
97222
US

IV. Provider business mailing address

14255 SW BRIGADOON CT
BEAVERTON OR
97005-3369
US

V. Phone/Fax

Practice location:
  • Phone: 971-206-5149
  • Fax: 971-206-5209
Mailing address:
  • Phone: 503-641-1475
  • Fax: 503-641-8548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2449
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: