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General NPI Number Information
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NPI Number | 1538192356
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Entity Type | Individual
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Provider Name | JENNIFER E. SCALISE PA
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 500 WEST BROADWAY
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City | MISSOULA
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State | MT
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Zip | 59802
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Country | US
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Telephone | 406-721-5600
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Fax | 406-721-5600
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Provider Business Mailing Address
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Address Line | PO BOX 31001-4110
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City | PASADENA
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State | CA
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Zip | 91110-4110
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Country | US
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Telephone | 406-329-5828
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Fax | 406-329-5864
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 558
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0003014
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MED-PAC-LIC-558
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License Number State | MT
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