Individual
SCOTT J PINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 361-5400
Mailing address
2913 DOUGLAS AVE, NEWBERG, OR 97132-1415
(503) 538-2942
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
17608
OR
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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