# MR. SCOTT MATTHEW LIGHT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1679653745
- **Gender:** Man
- **Credential:** P.A.-C.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AM0700X | Medical Physician Assistant | PA01153 | OR | — |
| 363AM0700X | Medical Physician Assistant | PA10005254 | WA | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 02/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 213187 | — | OR |
| 01 | — | PA01153 | OREGON STATE LICENSE | OR |
| 01 | — | PA10005254 | WA LICENCE | WA |