MR. SCOTT MATTHEW LIGHT (NPI# 1679653745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679653745 |
| Entity Type | Individual |
| Full Name | MR. SCOTT MATTHEW LIGHT |
| Credential | P.A.-C. |
| Practice Address |
1251 Ne Elm St Suite 1a Prineville OR 97754-1206 |
| Mailing Address |
838 Essex Ave Aberdeen WA 98520-2718 |
| Practice Telephone | 5414471680 |
| Practice Fax Number | 5414474670 |
| Mailing Telephone | 5037306719 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2012-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10005254 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA01153 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WA LICENCE | PA10005254 | 01 |
| OR | OREGON STATE LICENSE | PA01153 | 01 |
| OR | 213187 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841368909 | Scott Allen Light | Chiropractor | 267 Electric Ave, Westerville, OH 43081-2676 | 2006-11-30 |
| Street Address |
1251 NE ELM ST SUITE 1A |
| City | PRINEVILLE |
| State | OR |
| Zip Code | 97754-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982605911 | Kenneth D Long | Physician Assistant | 1251 Ne Elm St, Prineville, OR 97754 | 2005-08-01 |
| 1518404078 | Mary Katherine Brook | Peer Specialist | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2017-01-23 |
| 1790222487 | Tara Lee Fetterly | Peer Specialist | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2017-01-19 |
| 1699224899 | Casey Marker | Behavioral Analyst | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2016-09-28 |
| 1285183533 | Katie Morrison | Counselor | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2016-09-28 |
| 1760838668 | Proactive Physical Therapy - Prineville, LLC | Physical Therapist | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2016-05-10 |
| 1497115018 | Glenda Miller | Peer Specialist | 1251 Ne Elm St, Prineville, OR 97754 | 2016-02-24 |
| 1326406901 | Patricia Bates | Case Manager/Care Coordinator | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2016-02-10 |
| 1851756233 | Dawn Mountz | Counselor | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2015-12-29 |
| 1972974665 | Anne Stout | Counselor | 1251 Ne Elm St, Prineville, OR 97754-1206 | 2015-10-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598246290 | Phyllis Louise Young | Physical Therapy Assistant | 350 Ne Brennan Ln, Prineville, OR 97754 | 2018-08-22 |
| 1316424518 | Monte Bainbridge | Counselor | 1103 Ne Elm St Ste B, Prineville, OR 97754 | 2018-07-20 |
| 1841739760 | Gregory Wayne Sanders | Marriage & Family Therapist | 445 Nw 3rd Street, Prineville, OR 97754 | 2017-02-13 |
| 1114474962 | Amy R Duryea | Counselor | 1103 Ne Elm St., Prineville, OR 97754 | 2016-09-08 |
| 1669855052 | Rebecca L Griffith | Mechanotherapist | 298 N Holly St, Prineville, OR 97754 | 2015-07-02 |
| 1376810838 | Jessica Lynn Neely | Counselor | 1333 Nw 9th Street, Prineville, OR 97754 | 2011-11-28 |
| 1205076130 | Dean Arthur Laney | Registered Nurse | 375 Nw Beaver St., Suite 100, Prineville, OR 97754 | 2009-03-05 |
| 1699910513 | Ross E Weakley | Acupuncturist | 298 Sw Harwood, Prineville, OR 97754 | 2008-12-05 |
| 1326208752 | Laura Danielle Gratton | Family Medicine | 975 Nw Beaver Street, Prineville, OR 97754 | 2008-06-10 |
| 1811174550 | Central Oregon Eyecare, PC | Optometrist | 198 Ne Combs Flat Rd, Ste 120, Prineville, OR 97754 | 2008-01-24 |
| Find all providers in zip 97754 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811217078 | Lindsey Gail Mckay | Physician Assistant | 750 Nw 4th St, Prineville, OR 97754-1436 | 2010-06-10 |
| 1902248776 | Cascade Direct Care Inc | Physician Assistant | 750 Nw 4th St, Prineville, OR 97754-1436 | 2013-07-22 |
| 1740469378 | Leeann Cheryl Osborne | Physician Assistant | 375 Nw Beaver St, Suite 101, Prineville, OR 97754 | 2007-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808605 | Pilar Lorena Lopez | Physician Assistant | 7675 Sw Spruce St, Tigard, OR 97223-8723 | 2020-10-15 |
| 1730787615 | Michael Hisao Mun Ho Pang | Physician Assistant | 1245 Sw 160th Ave, Beaverton, OR 97006-5052 | 2020-10-13 |
| 1144834805 | Logan Michael Johnston | Physician Assistant | 3319 Edgeview Ln, Forest Grove, OR 97116-1094 | 2020-09-01 |
| 1285255851 | Darby Samantha Jalbert | Physician Assistant | 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 | 2020-05-05 |
| 1033751433 | Trisha K Loch | Physician Assistant | 781 W Central, Sutherlin, OR 97479 | 2019-10-17 |
| 1154805729 | Ronald William Strohmeyer | Physician Assistant | 2327 S.w. 4th Ave, Ontario, OR 97914 | 2018-09-19 |
| 1740797166 | Joseph Something | Physician Assistant | 4800 Sw 76th Ave, Portland, OR 97225-1804 | 2018-01-08 |
| 1235687013 | Satchel Harry | Physician Assistant | 417 Sw 117th Ave Fl 2, Portland, OR 97225-5924 | 2016-09-21 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1659828044 | Ryan Jones | Physician Assistant | 1775 Thompson Rd Bay Or97420, Coos Bay, OR 97420-2125 | 2016-09-02 |
| Find all providers with the same taxonomy | ||||
| City | PRINEVILLE |
| Zip Code | 97754 |
Please comment or provide details below to improve the information on MR. SCOTT MATTHEW LIGHT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.