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NPI 1144795428

NPI 1144795428 : KENNETH HWAY OTR/L : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1144795428
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    Entity Type          |    Individual 
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    Provider Name        |    KENNETH HWAY OTR/L
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/12/2018
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    Last Update Date     |    10/12/2018
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Provider Practice Location Address
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    Address Line         |    2121 PINE ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94115-2829
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    Country              |    US
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    Telephone            |    415-922-5085
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1730 26TH AVE 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94122-4316
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    Country              |    US
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    Telephone            |    415-759-9273
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    19230
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    License Number State |    CA
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