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General NPI Number Information
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NPI Number | 1194051839
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Entity Type | Organization
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Legal Business Name | PASIANA SPELLICY
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Dates
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Enumeration Date | 10/31/2009
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Last Update Date | 10/31/2009
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Provider Practice Location Address
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Address Line | 17 KUULA ST
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City | KAHULUI
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State | HI
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Zip | 96732-2906
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Country | US
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Telephone | 808-214-6965
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Fax |
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Provider Business Mailing Address
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Address Line | 17 KUULA ST
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City | KAHULUI
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State | HI
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Zip | 96732-2906
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Country | US
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Telephone | 808-214-6965
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Fax |
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Authorized Official
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Title or Position | CNA
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Name | MRS. PASIANA MAGSAYO SPELLICY
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Credential |
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Telephone | 808-214-6065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | W09834492-01
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License Number State | HI
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