Provider Demographics
NPI:1477730877
Name:TAYLOR, DARCY COATS (OD)
Entity Type:Individual
Prefix:DR
First Name:DARCY
Middle Name:COATS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 SW GRIFFITH DR STE 165
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-8731
Mailing Address - Country:US
Mailing Address - Phone:503-646-8592
Mailing Address - Fax:
Practice Address - Street 1:4655 SW GRIFFITH DR STE 165
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-8731
Practice Address - Country:US
Practice Address - Phone:503-646-8592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3232AT1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist