Provider Demographics
NPI:1891731816
Name:SCOTT, NATHAN L (OD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3142
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98807-3142
Mailing Address - Country:US
Mailing Address - Phone:509-860-1909
Mailing Address - Fax:509-886-2059
Practice Address - Street 1:126 E JOHNSON
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-3100
Practice Address - Country:US
Practice Address - Phone:509-682-2708
Practice Address - Fax:509-682-2713
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD3674152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2027845Medicaid
WA2027845Medicaid
U85521Medicare UPIN