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General NPI Number Information
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NPI Number | 1417181819
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Entity Type | Individual
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Provider Name | JOHN SCOPETTA MD
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Gender | Male
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 5350 TALLMAN AVE NW STE 510
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City | SEATTLE
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State | WA
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Zip | 98107-5910
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Country | US
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Telephone | 206-531-3114
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Fax | 425-688-8850
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Provider Business Mailing Address
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Address Line | 1793 13TH ST SE
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City | SALEM
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State | OR
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Zip | 97302-2541
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Country | US
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Telephone | 503-362-8385
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Fax | 503-362-8435
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 198045
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 198045
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD61081554
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License Number State | WA
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