Provider Demographics
NPI:1679576672
Name:PARIS, SCOTT (ARNP)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PARIS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 MAIN ST E
Mailing Address - Street 2:SUITE C
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-8988
Mailing Address - Country:US
Mailing Address - Phone:253-299-6556
Mailing Address - Fax:
Practice Address - Street 1:8910 MAIN ST E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-8988
Practice Address - Country:US
Practice Address - Phone:253-299-6556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006338363LP0808X, 363LP0808X
WAAP30006338RN00135307163WA0400X, 163WA2000X, 163W00000X, 163WC0400X, 163WC1600X, 163WN0800X, 163WP0000X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0193813OtherL & I
WA9644246Medicaid
WA9644246Medicaid
WA9644246Medicaid
WA8851074Medicare PIN