Individual
DR. SCOTT CABOT WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7157 SW BEVELAND RD, SUITE 100, TIGARD, OR 97223-9628
(503) 547-9505
Mailing address
7157 SW BEVELAND RD, SUITE 100, TIGARD, OR 97223-9628
(503) 547-9505
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
919
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042494
—
OR
Enumeration date
08/23/2005
Last updated
01/17/2013
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