Individual
SCOTT IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1955 27TH AVE, FOREST GROVE, OR 97116-2962
(503) 713-3367
Mailing address
1955 27TH AVE, FOREST GROVE, OR 97116-2962
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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