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NPI 1043253032

NPI 1043253032 : WILLIAM H O'GRADY DPT : PUYALLUP, WA

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General NPI Number Information
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    NPI Number           |    1043253032
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM H O'GRADY DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/14/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    8011 112TH STREET CT E 
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    City                 |    PUYALLUP
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    State                |    WA
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    Zip                  |    98373-7814
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    Country              |    US
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    Telephone            |    253-848-0662
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    Fax                  |    253-848-8567
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Provider Business Mailing Address
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    Address Line         |    9315 GRAVELLY LAKE DR SW SUITE 203
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    City                 |    LAKEWOOD
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    State                |    WA
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    Zip                  |    98499-1574
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    Country              |    US
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    Telephone            |    253-581-5200
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    Fax                  |    253-581-5203
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT00002841
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    6513
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    License Number State |    CA
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Taxonomy #3
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    2481
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    License Number State |    OR
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Taxonomy #4
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    2534
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    License Number State |    AZ
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Taxonomy #5
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1788
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    License Number State |    NV
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Taxonomy #6
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT 749
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    License Number State |    ID
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