Individual
KELLY SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
559 GLATT CIR STE 1, WOODBURN, OR 97071-9675
(503) 981-4591
(503) 982-3308
Mailing address
559 GLATT CIR STE 1, WOODBURN, OR 97071-9675
(503) 981-4591
(503) 982-3308
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
13672
OR
Other
Enumeration date
11/20/2007
Last updated
11/20/2007
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