Individual
SPENCER SCOTT ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
(360) 830-1100
Mailing address
2512 WHEATON WAY, BREMERTON, WA 98310-3399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00037962
WA
207RG0100X
Gastroenterology Physician
Primary
MD00037962
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131361
LABOR & INDUSTRIES
WA
01
—
7037RO
REGENCE BLUESHIELD
—
01
—
7254073
AETNA
—
05
—
8250938
—
WA
Enumeration date
06/11/2006
Last updated
03/07/2023
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