Healthcare Provider Details

I. General information

NPI: 1801852264
Provider Name (Legal Business Name): SCOTT NORMAN LOSK PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 NW VAUGHN ST SUITE 350
PORTLAND OR
97210-5311
US

IV. Provider business mailing address

2701 NW VAUGHN ST SUITE 350
PORTLAND OR
97210-5311
US

V. Phone/Fax

Practice location:
  • Phone: 503-972-9833
  • Fax: 503-293-1336
Mailing address:
  • Phone: 503-972-9833
  • Fax: 503-293-1336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number0922
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0922
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: