Individual
MR. SCOTT G SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3640 NW SAMARITAN DR STE 120, CORVALLIS, OR 97330-3738
(541) 768-5223
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
002083
CT
363AS0400X
Surgical Physician Assistant
0110002857
VA
363AS0400X
Surgical Physician Assistant
3418
CO
363AS0400X
Surgical Physician Assistant
Primary
PA179815
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497925135
—
VA
Enumeration date
03/10/2008
Last updated
04/30/2021
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