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Individual

TIMOTHY SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
350 S 8TH ST, LEBANON, OR 97355-2242
(541) 259-1221
Mailing address
333 LOMA LINDA LN, EUGENE, OR 97405-2711
(425) 260-7484

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015178
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015178
CONDITIONAL SPEECH-LANGUAGE PATHOLOGY LICENSE
OR
Enumeration date
09/25/2013
Last updated
09/25/2013
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