Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1907 | OR |
Y | 103TC0700X | Clinical Psychologist | 1907 | OR |
NPI | 1013052851 |
---|---|
Provider Name | Dr. Colleen Marie Scott |
First Address | Portland, OR 97220-5670 |
Second Address | Portland, OR 97220-5670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 23/09/2010 |