Provider Demographics
NPI:1891946570
Name:BRANCH, SCOTT MONTGOMERY (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MONTGOMERY
Last Name:BRANCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:820 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2028
Practice Address - Country:US
Practice Address - Phone:509-663-8711
Practice Address - Fax:509-665-6065
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60279981207R00000X, 208M00000X
OH34207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1891946570Medicaid
WAP01241799OtherRR MEDICARE POST 7/21/13
WA0295834OtherL&I
WA315902OtherL&I POST 7/21/13
WA1891946570Medicaid
WAG8909680Medicare PIN