MEDICARE: SCOTT C SLATTERY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD00037076	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144332339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT C SLATTERY MD

Provider Business Mailing Address
First Line	:	1900 COOKS HILL RD
Second Line	:
City	:	CENTRALIA
State	:	WA
Zip	:	98531-9073
Country	:	US
Telephone Number	:	360-736-2899
Fax Number	:	360-736-3136

Provider Business Practice Location Address
First Line	:	1900 COOKS HILL RD
Second Line	:
City	:	CENTRALIA
State	:	WA
Zip	:	98531-9073
Country	:	US
Telephone Number	:	360-736-2899
Fax Number	:	360-736-3136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ SCOTT C SLATTERY MD” Practice Location

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