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General NPI Number Information
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NPI Number | 1235371873
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Entity Type | Individual
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Provider Name | ANASTASIA S OLEINIKOV LMP
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Gender | Female
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 1800 SE MILE HILL DR SUITE 150
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City | PORT ORCHARD
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State | WA
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Zip | 98366-3511
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Country | US
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Telephone | 360-874-0232
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Fax | 360-874-0658
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Provider Business Mailing Address
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Address Line | 2018 46TH ST NW
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City | GIG HARBOR
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State | WA
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Zip | 98335-1412
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Country | US
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Telephone | 914-309-2278
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA60074580
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License Number State | WA
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