Provider Demographics
NPI:1174269963
Name:COATS, TAYLOR CORRINE (MA)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:CORRINE
Last Name:COATS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 SE PINE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1839
Mailing Address - Country:US
Mailing Address - Phone:571-309-3399
Mailing Address - Fax:
Practice Address - Street 1:3700 N WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1441
Practice Address - Country:US
Practice Address - Phone:503-281-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health