Individual
JACQUELINE SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4242 COMMERCE ST, SUITE A, EUGENE, OR 97402-5418
(541) 484-9632
(541) 484-7466
Mailing address
16083 SW UPPER BOONES FERRY RD, STE. 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
60259458
WA
225100000X
Physical Therapist
Primary
OR 61457
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0349710
WA L&I
OR
05
—
500696235
—
OR
01
—
P01338293
RR MEDICARE
WA
01
—
P01610736
RR MEDICARE
OR
Enumeration date
03/02/2012
Last updated
04/25/2016
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