Individual
SCOTT PECKENPAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
(360) 744-4989
Mailing address
3082 SE GROVEWOOD ST, PORT ORCHARD, WA 98367-9591
(360) 509-3298
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA61130139
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2177392
—
WA
Enumeration date
09/09/2019
Last updated
09/09/2021
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