Individual
DR. SCOTT LAWRENCE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
371 NE GARDEN VALLEY BLVD, ROSEBURG, OR 97470-2039
(541) 673-4166
Mailing address
371 NE GARDEN VALLEY BLVD, ROSEBURG, OR 97470-2039
(541) 673-4166
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2885AT
OR
152W00000X
Optometrist
OD3772
WA
152W00000X
Optometrist
OPT11957TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182779
OREGON HEALTH PLAN NUMBER
OR
01
—
804858000
BLUE CROSS PROVIDER NUMBE
—
Enumeration date
11/02/2005
Last updated
05/31/2011
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