Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | MD00044395 | WA |
NPI | 1295759587 |
---|---|
Provider Name | Dr. Scott B Roofe |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 09/08/2019 |