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General NPI Number Information
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NPI Number | 1073492005
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Entity Type | Individual
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Provider Name | LUIS ANTONIO GARCIA MA61559469
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Gender | Male
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3910 SUMMITVIEW AVE
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City | YAKIMA
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State | WA
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Zip | 98902-2780
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Country | US
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Telephone | 509-823-7592
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Fax | 509-424-3104
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Provider Business Mailing Address
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Address Line | PO BOX 433
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City | WHITE SWAN
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State | WA
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Zip | 98952-0433
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Country | US
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Telephone | 509-406-9593
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA61559469
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License Number State | WA
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