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NPI 1275638686

NPI 1275638686 : DR. ROCKNE K ELI : PUYALLUP, WA

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General NPI Number Information
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    NPI Number           |    1275638686
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    Entity Type          |    Individual 
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    Provider Name        |    DR. ROCKNE K ELI
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/13/2006
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    Last Update Date     |    08/29/2012
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Provider Practice Location Address
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    Address Line         |    1203 E MAIN 
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    City                 |    PUYALLUP
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    State                |    WA
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    Zip                  |    98372-3132
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    Country              |    US
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    Telephone            |    253-848-2244
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    Fax                  |    253-848-1337
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Provider Business Mailing Address
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    Address Line         |    1203 E MAIN 
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    City                 |    PUYALLUP
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    State                |    WA
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    Zip                  |    98372-3132
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    Country              |    US
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    Telephone            |    253-848-2244
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    Fax                  |    253-848-1337
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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        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    3384
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    License Number State |    WA
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