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General NPI Number Information
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NPI Number | 1457178816
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Entity Type | Individual
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Provider Name | DEVIN PHILLIP TORREZ
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Gender | Male
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 182 SW ACADEMY ST STE 204
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City | DALLAS
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State | OR
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Zip | 97338-1996
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Country | US
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Telephone | 503-623-9289
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Fax |
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Provider Business Mailing Address
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Address Line | 5111 ZOSEL AVE S
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City | SALEM
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State | OR
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Zip | 97306-2103
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Country | US
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Telephone | 503-979-1284
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 24-QMHA-R-5836
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License Number State | OR
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