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General NPI Number Information
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NPI Number | 1285176883
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Entity Type | Individual
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Provider Name | SCOTT A VIGNOLA MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/14/2016
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 1020 SW TAYLOR ST STE 435
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City | PORTLAND
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State | OR
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Zip | 97205-2509
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Country | US
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Telephone | 503-449-3586
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 SW TAYLOR ST STE 435
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City | PORTLAND
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State | OR
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Zip | 97205-2509
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Country | US
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Telephone | 503-449-3586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW.61332113
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L13880
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License Number State | OR
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