Healthcare Provider Details

I. General information

NPI: 1114450293
Provider Name (Legal Business Name): HEATHER SCOTT PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

492 E 13TH AVE STE 106
EUGENE OR
97401-4250
US

IV. Provider business mailing address

492 E 13TH AVE STE 106
EUGENE OR
97401-4250
US

V. Phone/Fax

Practice location:
  • Phone: 541-543-1702
  • Fax:
Mailing address:
  • Phone: 541-543-1702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1571
License Number StateOR

VIII. Authorized Official

Name: HEATHER ANNE SCOTT
Title or Position: LICENSED PSYCHOLOGIST/OWNER
Credential: PHD
Phone: 541-543-1702