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General NPI Number Information
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NPI Number | 1306725502
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Entity Type | Individual
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Provider Name | AARON SMITH
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Gender | Male
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 913 SW 16TH AVE
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City | PORTLAND
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State | OR
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Zip | 97205-1730
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Country | US
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Telephone | 503-228-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 SE CENTER ST
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City | PORTLAND
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State | OR
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Zip | 97206-3247
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Country | US
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Telephone | 956-245-7302
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 26057
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License Number State | OR
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