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General NPI Number Information
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NPI Number | 1407792922
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Entity Type | Individual
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Provider Name | SCOTT MANNING RN, BSN
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Gender | Male
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 30 NE MLK BLVD
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City | PORTLAND
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State | OR
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Zip | 97232-2941
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Country | US
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Telephone | 971-346-4710
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Fax |
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Provider Business Mailing Address
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Address Line | 1716 HALLINAN ST
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-6100
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Country | US
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Telephone |
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 2012241371RN
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License Number State | OR
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