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General NPI Number Information
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NPI Number | 1417155391
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Entity Type | Individual
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Provider Name | SCOTT SIMNER SPENCER M.D, MPH
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 2701 NW VAUGHN ST. SUITE 360
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City | PORTLAN
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State | OR
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Zip | 97210
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Country | US
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Telephone | 503-227-0671
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Fax | 503-227-0676
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Provider Business Mailing Address
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Address Line | 1510 DIVISION ST., STE. 280
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City | OREGON CITY
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State | OR
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Zip | 97045
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Country | US
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Telephone | 503-905-3400
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Fax | 503-905-3399
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4811
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD158012
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License Number State | OR
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