Provider Demographics
NPI:1326832536
Name:SIMONDS, TAYLOR (THERAPIST INTERN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:SIMONDS
Suffix:
Gender:
Credentials:THERAPIST INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 SE REEDWAY ST APT 203
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5153
Mailing Address - Country:US
Mailing Address - Phone:541-905-2184
Mailing Address - Fax:
Practice Address - Street 1:8645 SE SUNNYBROOK BLVD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6841
Practice Address - Country:US
Practice Address - Phone:503-659-1694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program