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General NPI Number Information
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NPI Number | 1093960486
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC ASSOCIATES INC
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 925 E POLSTON AVE SUITE B
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City | POST FALLS
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State | ID
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Zip | 83854-9049
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Country | US
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Telephone | 208-777-8273
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Fax | 208-777-8275
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Provider Business Mailing Address
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Address Line | 11481 SW HALL BLVD SUITE 201
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City | PORTLAND
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State | OR
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Zip | 97223-8403
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Country | US
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Telephone | 800-219-8835
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Fax | 503-639-9699
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Authorized Official
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Title or Position | DIRECTOR OF TAI SYSTEMS
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Name | MR. TODD GIFFORD
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Credential | MS, PT
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Telephone | 800-219-8835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | OR
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