Basic Information
| Provider Information | |||||||||
| NPI: | 1326571548 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIGGERSTAFF | ||||||||
| FirstName: | SCOTT | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3181 SW SAM JACKSON PARK RD | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972393011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034945262 | ||||||||
| FaxNumber: | 5034185505 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 WASHINGTON AVE SE STE 200 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554142924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128840600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2017 | ||||||||
| LastUpdateDate: | 11/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DO204125 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | DO204125 | OR | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 72847 | MN | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 72847 | MN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.