=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912037375
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SCOTT L AUSTIN BC-HIS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2007
-----------------------------------------------------
Last Update Date | 03/31/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1939 E BURNSIDE ST
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97214-1535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-233-6141
-----------------------------------------------------
Fax | 503-233-2889
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26222 RANCH ROAD 12
-----------------------------------------------------
City | DRIPPING SPRINGS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78620-4903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-858-0300
-----------------------------------------------------
Fax | 512-858-2714
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | HAS-P-498672
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | HA00000774
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------