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General NPI Number Information
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NPI Number | 1457221103
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Entity Type | Organization
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Legal Business Name | DENALI SURGERY CENTER LLC
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 3500 NE JOHN OLSEN AVE
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City | HILLSBORO
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State | OR
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Zip | 97124
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Country | US
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Telephone | 503-639-6571
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22009
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City | PORTLAND
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State | OR
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Zip | 97269-2009
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Country | US
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Telephone | 503-558-7372
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Fax | 503-344-5140
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Authorized Official
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Title or Position | CEO
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Name | BRETT WILLIAMS
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Credential |
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Telephone | 503-344-5101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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