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General NPI Number Information
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NPI Number | 1285857011
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Entity Type | Individual
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Provider Name | KATHERINE JANE FARRELL DMD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3489 3RD STR STE D
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City | HUBBARD
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State | OR
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Zip | 97032
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Country | US
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Telephone | 503-982-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 11900 SW RIVERVIEW LN
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City | WILSONVILLE
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State | OR
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Zip | 97070-7537
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Country | US
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Telephone | 503-582-8588
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D8450
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License Number State | OR
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