Provider Demographics
NPI:1316715121
Name:TAYLOR, WENDELL COLE (DC)
Entity type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:COLE
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17055 K16 HWY
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:KS
Mailing Address - Zip Code:66066-4178
Mailing Address - Country:US
Mailing Address - Phone:913-775-1608
Mailing Address - Fax:
Practice Address - Street 1:524 SE 14TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2428
Practice Address - Country:US
Practice Address - Phone:971-544-7058
Practice Address - Fax:971-244-9058
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor