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General NPI Number Information
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NPI Number | 1225778285
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Entity Type | Organization
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Legal Business Name | FOCUS FUSION MASSAGE AND WELLNESS LLC
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 1755 MOUNT HOOD AVE STE 124
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City | WOODBURN
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State | OR
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Zip | 97071-9096
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Country | US
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Telephone | 503-980-2000
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Fax | 267-430-5571
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Provider Business Mailing Address
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Address Line | PO BOX 633
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City | HUBBARD
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State | OR
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Zip | 97032-0633
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Country | US
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Telephone | 503-422-5571
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LOWELL WELCH
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Credential |
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Telephone | 503-422-5517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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