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Individual

STEPHANIE R SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2042 NE WILLIAMSON CT, BEND, OR 97701-3760
(541) 706-6905
(541) 706-6906
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 706-6905
(541) 706-6906

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01424
OR
363AM0700X
Medical Physician Assistant
2730
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500605527
OR
05
738338
AZ
Enumeration date
08/15/2005
Last updated
05/29/2020
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