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NPI 1396000113

NPI 1396000113 : JAMES SPETZ L.M.P. : TACOMA, WA

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General NPI Number Information
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    NPI Number           |    1396000113
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES SPETZ L.M.P.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/09/2012
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    Last Update Date     |    07/09/2012
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Provider Practice Location Address
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    Address Line         |    6029 S. LAWRENCE ST. 
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    City                 |    TACOMA
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    State                |    WA
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    Zip                  |    98409-4156
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    Country              |    US
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    Telephone            |    253-234-5640
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6029 S. LAWRENCE ST. 
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    City                 |    TACOMA
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    State                |    WA
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    Zip                  |    98409-4156
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    Country              |    US
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    Telephone            |    425-344-3294
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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       |    MA60112115
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    License Number State |    WA
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