Provider Demographics
NPI:1922082338
Name:JENNIFER A SCOTT MD LLC
Entity Type:Organization
Organization Name:JENNIFER A SCOTT MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF JENNIFER A SCOTT MD LLC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-439-8086
Mailing Address - Street 1:3000 NW STUCKI PL
Mailing Address - Street 2:STE 220
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7107
Mailing Address - Country:US
Mailing Address - Phone:503-439-8086
Mailing Address - Fax:503-439-9096
Practice Address - Street 1:3000 NW STUCKI PL
Practice Address - Street 2:STE 220
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7107
Practice Address - Country:US
Practice Address - Phone:503-439-8086
Practice Address - Fax:503-439-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD248832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty