Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 31973 | NE |
NPI | 1023518982 |
---|---|
Provider Name | Dr. Sean Eliot Scott |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2018 |
Last Update Date | 17/11/2019 |