Healthcare Provider Details

I. General information

NPI: 1881779601
Provider Name (Legal Business Name): DAVID T SCOTT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTER ON HUMAN DEVELOPMENT AND DISABILITY 1959 NE PACIFIC ST
SEATTLE WA
98195-7920
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4317
  • Fax: 206-598-7815
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00001778
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPY00001778
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: