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General NPI Number Information
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NPI Number | 1306771308
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Entity Type | Individual
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Provider Name | MITCHELL HIROSE
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Gender | Male
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Dates
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Enumeration Date | 06/13/2026
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Last Update Date | 06/13/2026
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Provider Practice Location Address
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Address Line | 7305 SE CIRCUIT DR STE 140
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City | HILLSBORO
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State | OR
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Zip | 97129-1961
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Country | US
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Telephone | 971-501-4906
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 NE 91ST AVE APT 633
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City | HILLSBORO
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State | OR
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Zip | 97006-7543
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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