Provider Demographics
NPI:1477600229
Name:SCOTT R. WALKER, DMD, PC
Entity Type:Organization
Organization Name:SCOTT R. WALKER, DMD, PC
Other - Org Name:MURRAY SCHOLLS FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-590-7574
Mailing Address - Street 1:14845 SW MURRAY SCHOLLS DR
Mailing Address - Street 2:SUITE 113
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9237
Mailing Address - Country:US
Mailing Address - Phone:503-590-7574
Mailing Address - Fax:503-590-8664
Practice Address - Street 1:14845 SW MURRAY SCHOLLS DR
Practice Address - Street 2:SUITE 113
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-9237
Practice Address - Country:US
Practice Address - Phone:503-590-7574
Practice Address - Fax:503-590-8664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR=========OtherTAX IDENTIFICATION NUMBER