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Individual

BRIAN PAUL SCOTTOLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
707 SW GAINES ST, CDRC-P, PORTLAND, OR 97239-1507
(503) 494-2613
Mailing address
707 SW GAINES ST., CDRC-P, PORTLAND, OR 97239
(503) 494-2613

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A66414
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
160149
OR
2080N0001X
Neonatal-Perinatal Medicine Physician
A66414
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD60211161
WA
2080P0203X
Pediatric Critical Care Medicine Physician
A66414
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A664140
CA
Enumeration date
06/27/2006
Last updated
12/03/2021
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