Provider Demographics
NPI:1407892185
Name:SCOTT, BJ (MD)
Entity Type:Individual
Prefix:DR
First Name:BJ
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 SW BARNES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6642
Mailing Address - Country:US
Mailing Address - Phone:035-292-9560
Mailing Address - Fax:
Practice Address - Street 1:9450 SW BARNES RD STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6642
Practice Address - Country:US
Practice Address - Phone:503-292-9560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD31640207RG0300X
ORMD20406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORG46458Medicare UPIN
OR110244303OtherRR MEDICARE - PHS
ORG46458Medicare UPIN
ORR160244Medicare PIN
ORR160243Medicare PIN
ORR160242Medicare PIN
ORR160246Medicare PIN
ORR160241Medicare PIN
OR150410Medicaid
ORR160247Medicare PIN