Provider Demographics
NPI:1710994785
Name:LINSCOTT, JEAN L (PH D)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:L
Last Name:LINSCOTT
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 KRUSE WAY
Mailing Address - Street 2:STE 340
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3586
Mailing Address - Country:US
Mailing Address - Phone:503-977-0400
Mailing Address - Fax:503-619-0076
Practice Address - Street 1:4550 KRUSE WAY
Practice Address - Street 2:STE 340
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3586
Practice Address - Country:US
Practice Address - Phone:503-977-0400
Practice Address - Fax:503-635-0583
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1445103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical