Provider Demographics
NPI:1053716498
Name:TAYLOR, ELINOR (QMHP)
Entity type:Individual
Prefix:
First Name:ELINOR
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 CHURCH ST SE
Mailing Address - Street 2:UNIT 401
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3831
Mailing Address - Country:US
Mailing Address - Phone:071-240-7788
Mailing Address - Fax:
Practice Address - Street 1:3878 BEVERLY AVE NE
Practice Address - Street 2:SUITE H
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1394
Practice Address - Country:US
Practice Address - Phone:503-576-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health