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General NPI Number Information
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NPI Number | 1568004497
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Entity Type | Individual
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Provider Name | DIANA LYNNE SCARBOROUGH OTR
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Gender | Female
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 3615 SPICER DR SE
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City | ALBANY
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State | OR
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Zip | 97322-7043
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Country | US
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Telephone | 541-967-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 526 NW 9TH ST
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City | CORVALLIS
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State | OR
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Zip | 97330-6135
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Country | US
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Telephone | 208-346-2991
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT1909
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 404050
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License Number State | OR
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