Provider Demographics
NPI:1841381423
Name:SCOTT, THERESE M (DO)
Entity Type:Individual
Prefix:DR
First Name:THERESE
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11131 SE 190TH CT
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089
Mailing Address - Country:US
Mailing Address - Phone:503-558-8918
Mailing Address - Fax:503-558-9712
Practice Address - Street 1:11131 SE 190TH CT
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:OR
Practice Address - Zip Code:97089
Practice Address - Country:US
Practice Address - Phone:503-558-8918
Practice Address - Fax:503-558-9712
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17539207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine