Healthcare Provider Details

I. General information

NPI: 1912037375
Provider Name (Legal Business Name): SCOTT L AUSTIN BC-HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 E BURNSIDE ST
PORTLAND OR
97214-1535
US

IV. Provider business mailing address

26222 RANCH ROAD 12
DRIPPING SPRINGS TX
78620-4903
US

V. Phone/Fax

Practice location:
  • Phone: 503-233-6141
  • Fax: 503-233-2889
Mailing address:
  • Phone: 512-858-0300
  • Fax: 512-858-2714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAS-P-498672
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA00000774
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: