Provider Demographics
NPI:1356088843
Name:NELSON, TAYLOR JORDAN (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JORDAN
Last Name:NELSON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 E SPOKANE FALLS BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-5082
Mailing Address - Country:US
Mailing Address - Phone:509-435-0481
Mailing Address - Fax:509-435-0485
Practice Address - Street 1:528 E SPOKANE FALLS BLVD STE 401
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5082
Practice Address - Country:US
Practice Address - Phone:509-435-0481
Practice Address - Fax:509-435-0485
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61291393225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist