Provider Demographics
NPI:1437631926
Name:ALDERSON, TAYLOR (LMFT)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:
Last Name:ALDERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:ALDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1470 NW GLISAN STREET TAYLOR ALDERSON,
Mailing Address - Street 2:1470 NW GLISAN STREET SUITE 919
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209
Mailing Address - Country:US
Mailing Address - Phone:310-210-9510
Mailing Address - Fax:971-275-1838
Practice Address - Street 1:1470 NW GLISAN ST APT 919
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-4087
Practice Address - Country:US
Practice Address - Phone:310-210-9510
Practice Address - Fax:971-275-1838
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120638106H00000X
ORT1880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500808079Medicaid