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General NPI Number Information
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NPI Number | 1255375945
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Entity Type | Organization
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Legal Business Name | CLALLAM ANESTHESIOLOGIST ASSOCIATED PLLC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | OLYMPIC MEDICAL CENTER 939 CAROLINE STREET
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City | PORT ANGELES
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State | WA
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Zip | 98362
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Country | US
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Telephone | 360-417-7450
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 97115
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City | LAKEWOOD
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State | WA
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Zip | 98497-0115
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Country | US
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Telephone | 253-588-7911
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Fax | 253-974-6774
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | MR. MATTHEW BARTON
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Credential | MD
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Telephone | 360-683-4877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD00033499
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License Number State | WA
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