Scollard, Blaise Dennis Maxwell

Scollard, Blaise Dennis Maxwell is an individual health care provider with primary practice located at 10180 Se Sunnyside Rd , Clackamas OR 97015-8970. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Scollard, Blaise Dennis Maxwell can be contacted via phone (503) 571-3820.

Contact Information

Primary practice address
10180 Se Sunnyside Rd Clackamas OR 97015-8970
Phone: (503) 571-3820
Fax: (503) 571-5838
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 10394 Oregon

Profile Details

NPI number 1619050747
LBN Legal business name Scollard, Blaise Dennis Maxwell
Credentials PSY.D.M.A.CCC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated May 1st, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619050747 NPPES
Oregon MEDICAID 28605

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