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General NPI Number Information
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NPI Number | 1437192036
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Entity Type | Individual
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Provider Name | MARK CECIL WESTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 19255 SW 65TH AVE SUITE 110
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City | TUALATIN
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State | OR
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Zip | 97062-7451
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Country | US
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Telephone | 503-208-9432
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Fax | 503-673-1520
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Provider Business Mailing Address
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Address Line | 19255 SW 65TH AVE SUITE 110
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City | TUALATIN
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State | OR
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Zip | 97062-7451
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Country | US
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Telephone | 503-208-9432
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Fax | 503-673-1520
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | MD22218
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License Number State | OR
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