Provider Demographics
NPI:1316368186
Name:DEVLIN, SCOTT H (PHARMD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:H
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10775 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3001
Mailing Address - Country:US
Mailing Address - Phone:503-207-0646
Mailing Address - Fax:
Practice Address - Street 1:10775 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3001
Practice Address - Country:US
Practice Address - Phone:503-207-0646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-22
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80588183500000X
ORRPH-0016702183500000X, 1835P0018X, 1835P0018X
WAPH608650321835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2170990Medicaid
CA80588OtherPHARMACIST LICENSE
ORRPH-0016702OtherPHARMACIST LICENSE
WAPH60865032OtherPHARMACIST LICENSE