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General NPI Number Information
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NPI Number | 1447283866
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Entity Type | Individual
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Provider Name | JAY HAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 1211 24TH ST
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City | ANACORTES
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State | WA
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Zip | 98221-2557
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Country | US
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Telephone | 360-293-3181
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 189
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City | COUPEVILLE
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State | WA
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Zip | 98239-0189
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Country | US
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Telephone | 360-678-4071
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Fax | 360-678-6014
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD00022934
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License Number State | WA
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