Provider Demographics
NPI:1588139539
Name:MORRIS, SCOTTY (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTTY
Middle Name:
Last Name:MORRIS
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 NW COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-3273
Mailing Address - Country:US
Mailing Address - Phone:503-629-0366
Mailing Address - Fax:
Practice Address - Street 1:5880 NE CORNELL RD STE B
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9075
Practice Address - Country:US
Practice Address - Phone:503-905-2828
Practice Address - Fax:503-905-2829
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4378ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist