Provider Demographics
NPI:1770101776
Name:ECKEL, TAYLOR REBECCA (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:REBECCA
Last Name:ECKEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:CARTEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:485 SE 14TH AVE APT 403
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5765
Mailing Address - Country:US
Mailing Address - Phone:703-403-5794
Mailing Address - Fax:
Practice Address - Street 1:710 NE HOLLADAY ST STE 150
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2168
Practice Address - Country:US
Practice Address - Phone:503-308-8012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP004600T225100000X
OR63657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist