Individual
KIMBERLEY J. SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9701 SW BARNES RD STE 300, PORTLAND, OR 97225-6689
(503) 297-8081
(503) 292-6601
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
6382
AZ
363AM0700X
Medical Physician Assistant
Primary
PA204268
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0207736
LABOR & IND
WA
05
—
500604767
—
OR
05
—
8450082
—
WA
01
—
8941182
CRIME VICTIMS
WA
01
—
P00336906
RR MEDICARE
—
Enumeration date
03/16/2006
Last updated
12/18/2024
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