Individual provider · Type 1 NPI

Scott Matthew Light, P.A.-C.

Medical Physician Assistant · Prineville, OR

NPI number 1679653745 Active

Practice location

1251 NE Elm St, Suite 1A
Prineville, OR 97754-1206

Call (541) 447-1680 Map

Fax (541) 447-4670

Mailing address

838 Essex Ave
Aberdeen, WA 98520-2718

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XPA01153 (OR)
Medical Physician Assistant Primary 363AM0700XPA10005254 (WA)

Medical Physician Assistant: Definition to come...

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About NPI 1679653745

Scott Matthew Light, P.A.-C.'s National Provider Identifier is 1679653745, issued on Oct 16, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Prineville, OR. The record was last updated on Feb 23, 2012.