Provider Demographics
NPI:1700352523
Name:DOWNEY, SCOTT (BSCPT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:DOWNEY
Suffix:
Gender:M
Credentials:BSCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 KAMOKILA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2055
Mailing Address - Country:US
Mailing Address - Phone:808-674-9998
Mailing Address - Fax:
Practice Address - Street 1:338 KAMOKILA BLVD
Practice Address - Street 2:201
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2055
Practice Address - Country:US
Practice Address - Phone:808-674-9998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-4677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist