Healthcare Provider Details

I. General information

NPI: 1992021059
Provider Name (Legal Business Name): SONJA L SKOVSTED P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SONJA L SCOTT P.A.

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13200 SW PACIFIC HWY
TIGARD OR
97223-4828
US

IV. Provider business mailing address

PO BOX 1517
PENDLETON OR
97801-0410
US

V. Phone/Fax

Practice location:
  • Phone: 503-598-2000
  • Fax: 503-639-0920
Mailing address:
  • Phone: 877-708-1119
  • Fax: 541-278-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTA60120274
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA154573
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60120278
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: