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General NPI Number Information
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NPI Number | 1215961487
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Entity Type | Individual
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Provider Name | GEORGE WALDMANN M. D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1800 SW 1ST AVE SUITE 380
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City | PORTLAND
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State | OR
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Zip | 97201-5333
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Country | US
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Telephone | 503-944-8810
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Fax | 503-944-8814
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Provider Business Mailing Address
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Address Line | 1235 NE 37TH AVE
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City | PORTLAND
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State | OR
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Zip | 97232-1977
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Country | US
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Telephone | 503-231-7385
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 07511
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License Number State | OR
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