Individual
MARVIN SCOTVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 E NOB HILL BLVD, YAKIMA, WA 98901-3534
(509) 248-3334
(509) 453-6144
Mailing address
602 E NOB HILL BLVD, YAKIMA, WA 98901-3534
(509) 248-3334
(509) 453-6144
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00009476
WA
208000000X
Pediatrics Physician
MD00009476
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44501
L & I
WA
01
—
4963
GROUP HEALTH
—
01
—
8372302
CHPW
WA
05
—
8372302
—
WA
01
—
911019392
COMMERCIAL
—
01
—
9390SC
REGENCE
WA
Enumeration date
10/05/2006
Last updated
03/23/2021
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