Healthcare Provider Details

I. General information

NPI: 1639868383
Provider Name (Legal Business Name): KATHRYN SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATY SCOTT

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 CHAMBERS ST
EUGENE OR
97402
US

IV. Provider business mailing address

1005 PROSPECT ST, UNIT A
KLAMATH FALLS OR
97601
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-3550
  • Fax:
Mailing address:
  • Phone: 303-552-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPI-0014280
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRPH-0019231
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: