Provider Demographics
NPI:1912037375
Name:AUSTIN, SCOTT L (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:L
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26222 RANCH ROAD 12
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4903
Mailing Address - Country:US
Mailing Address - Phone:512-858-0300
Mailing Address - Fax:512-858-2714
Practice Address - Street 1:1939 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1535
Practice Address - Country:US
Practice Address - Phone:503-233-6141
Practice Address - Fax:503-233-2889
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-498672237700000X
WAHA00000774237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9178104Medicaid
OR212936Medicaid
2432417000OtherFEDERAL WORKERS COMP
WA0161384OtherWORKERS COMP
WA9178104Medicaid