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Individual

LUCAS P. SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
11307 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-3024
(253) 985-6134
(253) 627-6576
Mailing address
11307 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-3024
(253) 985-6134
(253) 627-6576

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.300403
LA
363A00000X
Physician Assistant
Primary
PA60894029
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2111758
WA
Enumeration date
11/17/2015
Last updated
12/09/2020
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