person
Mr. Scott Matthew Light, PA-C
Medical Physician Assistant in Prineville, Oregon
NPI 1679653745

Scott Matthew Light is a Medical Physician Assistant based in Aberdeen, OR and is specialized in Medical. Scott Matthew Light practices in Prineville, OR and has the professional credentials of PA-C. The NPI Number for Scott Matthew Light is 1679653745 and holds a License No. PA01153 (Oregon).

The current practice location address for Scott Matthew Light is 1251 Ne Elm St, Prineville, OR and can be reached out via phone at 541-447-1680 and via fax at 541-447-4670.

Location: 1251 Ne Elm St, Prineville, OR, 98520-2718
person
Provider Profile Details
NPI Number
1679653745
Provider Name
Scott Matthew Light
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1251 Ne Elm St, Prineville, OR, 98520-2718
Phone Number
541-447-1680
Fax Number
541-447-4670
Provider Enumeration Date
10/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA01153 01 OR OREGON STATE LICENSE
213187 05 OR
PA10005254 01 WA WA LICENCE
institution
Provider Business Practice Location Address Details
Address
1251 Ne Elm St
City
State
Zip
97754-1206
Phone Number
541-447-1680
Fax Number
541-447-4670
person
Provider Business Mailing Address Details
Address
1251 Ne Elm St
City
State
Zip
97754-1206
Phone Number
541-447-1680
Fax Number
541-447-4670
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA01153 (Oregon)
Definition
Definition to come...
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