| Scott Cabot Willis, Phd Pc | |
|
7157 Sw Beveland Rd Suite 100 Tigard OR 97223-9628 | |
| (503) 547-9505 | |
| Not Available |
| Full Name | Scott Cabot Willis, Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 7157 Sw Beveland Rd, Tigard, Oregon |
| Authorized Official Name and Position | Scott Cabot Willis (PRESIDENT) |
| Authorized Official Contact | 5035479505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Cabot Willis, Phd Pc 7157 Sw Beveland Rd Suite 100 Tigard OR 97223-9628 Ph: (503) 547-9505 | Scott Cabot Willis, Phd Pc 7157 Sw Beveland Rd Suite 100 Tigard OR 97223-9628 Ph: (503) 547-9505 |
| NPI Number | 1962636860 |
|---|---|
| Provider Enumeration Date | 05/06/2009 |
| Last Update Date | 01/17/2013 |
| Medicare PECOS PAC ID | 3274682414 |
|---|---|
| Medicare Enrollment ID | O20090519000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962636860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 919 (Oregon) | Primary |
| Provider Name | Scott C Willis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679566848 PECOS PAC ID: 3779632906 Enrollment ID: I20090519000292 |
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