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General NPI Number Information
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NPI Number | 1124138219
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Entity Type | Individual
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Provider Name | ROBERT BRUCE MONTGOMERY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1959 NE PACIFIC ST BOX 356158
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City | SEATTLE
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State | WA
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Zip | 98195-0001
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Country | US
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Telephone | 206-598-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 204 130TH AVE SE
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City | BELLEVUE
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State | WA
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Zip | 98005-3628
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Country | US
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Telephone |
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | MD00027441
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License Number State | WA
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