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General NPI Number Information
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NPI Number | 1427670520
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Entity Type | Individual
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Provider Name | MATTHEW ALAN RAND PA
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Gender | Male
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 4407 FAIRMOUNT AVE
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City | PORT ANGELES
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State | WA
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Zip | 98363-9514
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Country | US
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Telephone | 360-457-0760
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Fax | 360-994-4975
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Provider Business Mailing Address
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Address Line | 1793 13TH ST SE
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City | SALEM
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State | OR
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Zip | 97302-2541
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Country | US
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Telephone | 503-362-8385
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Fax | 503-362-8435
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5039-23
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA61323159
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License Number State | WA
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