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General NPI Number Information
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NPI Number | 1790911576
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Entity Type | Individual
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Provider Name | SCOTT ERIC BEVANS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2009
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 316 MARTIN LUTHER KING JR WAY STE 305
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City | TACOMA
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State | WA
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Zip | 98405-4260
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Country | US
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Telephone | 253-403-0065
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Fax |
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Provider Business Mailing Address
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Address Line | 316 MARTIN LUTHER KING JR WAY STE 305
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City | TACOMA
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State | WA
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Zip | 98405-4260
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Country | US
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Telephone | 253-403-0065
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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 | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | R4944
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | MD60443147
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD60443147
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | MD-21894
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License Number State | HI
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Taxonomy #5
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | MD-21894
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License Number State | HI
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25871
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License Number State | NE
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Taxonomy #7
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | MD60443147
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License Number State | WA
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