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General NPI Number Information
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NPI Number | 1306400163
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Entity Type | Individual
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Provider Name | MIKE HAIYU BAO MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2019
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1100 9TH AVE
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City | SEATTLE
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State | WA
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Zip | 98101-2756
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Country | US
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Telephone | 206-223-6851
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Fax | 206-344-8804
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Provider Business Mailing Address
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Address Line | PO BOX 741515
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City | LOS ANGELES
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State | CA
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Zip | 90074-1515
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Country | US
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Telephone | 206-223-6851
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Fax | 206-344-8804
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD61529018
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License Number State | WA
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