Provider Demographics
NPI:1659499507
Name:SCOTT, GARRETT RANSOM (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:RANSOM
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4137
Mailing Address - Country:US
Mailing Address - Phone:503-640-3708
Mailing Address - Fax:503-693-0441
Practice Address - Street 1:512 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4137
Practice Address - Country:US
Practice Address - Phone:503-640-3708
Practice Address - Fax:503-693-0441
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD28752207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500605160Medicaid
OR500605160Medicaid