Provider Demographics
NPI:1457598203
Name:SCOTT, ANDREW (ND)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-2539
Mailing Address - Country:US
Mailing Address - Phone:541-663-6963
Mailing Address - Fax:
Practice Address - Street 1:1405 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2539
Practice Address - Country:US
Practice Address - Phone:541-663-6963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1658175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath