Provider Demographics
NPI:1316250335
Name:SYPHER, SCOTT (CPO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:SYPHER
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NW GILMAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2445
Mailing Address - Country:US
Mailing Address - Phone:425-427-8900
Mailing Address - Fax:425-427-8884
Practice Address - Street 1:600 NW GILMAN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2445
Practice Address - Country:US
Practice Address - Phone:425-427-8900
Practice Address - Fax:425-427-8884
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOI00000274222Z00000X
WAPS00000275224P00000X, 225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter