Individual
SCOTT J TIBBITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3425 ENSIGN RD NE, SUITE 220, OLYMPIA, WA 98506-5425
(360) 491-1112
(360) 493-8160
Mailing address
PO BOX 3360, SUITE 220, PORTLAND, OR 97208-3360
(360) 493-4069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00030644
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0149441
LABOR & INDUSTRIES
WA
01
—
110221313
RAILROAD MEDICARE
WA
01
—
3911TI
COUNTY
WA
01
—
539787389
CIGNA HEALTH INSURANCE
WA
05
—
8148694
—
WA
Enumeration date
12/13/2006
Last updated
11/03/2016
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