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General NPI Number Information
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NPI Number | 1184178949
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Entity Type | Organization
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Legal Business Name | PAIN CARE ASSOCIATES
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 801 SW 16TH ST SUITE 121
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City | RENTON
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State | WA
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Zip | 98057-2697
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Country | US
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Telephone | 206-805-8885
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Fax | 206-805-8886
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Provider Business Mailing Address
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Address Line | PO BOX 88357
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City | TUKWILA
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State | WA
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Zip | 98138-2357
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Country | US
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Telephone | 206-805-8885
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Fax | 206-805-8886
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Authorized Official
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Title or Position | CONTROLLER
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Name | GREG FRANKLIN
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Credential |
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Telephone | 206-805-8885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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