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General NPI Number Information
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NPI Number | 1245770890
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Entity Type | Organization
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Legal Business Name | WOLF CROW MEDICINE
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 6118 SE BELMONT STREET #405
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City | PORTLAND
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State | OR
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Zip | 97215
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Country | US
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Telephone | 503-701-6077
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Fax | 503-776-3106
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Provider Business Mailing Address
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Address Line | 411 NE 57TH AVENUE APT B
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City | PORTLAND
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State | OR
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Zip | 97213
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Country | US
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Telephone | 503-701-6077
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Fax | 503-776-3106
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | MS. J WHISKEY NORTHROP
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Credential | LAC
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Telephone | 503-701-6077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC173827
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License Number State | OR
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