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General NPI Number Information
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NPI Number | 1467688945
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Entity Type | Organization
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Legal Business Name | JAMES C. SIMMONS
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 06/10/2009
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Provider Practice Location Address
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Address Line | 411 STRANDER BLVD SUITE 202
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City | TUKWILA
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State | WA
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Zip | 98188-2935
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Country | US
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Telephone | 206-575-4396
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Fax | 206-575-8615
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Provider Business Mailing Address
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Address Line | 411 STRANDER BLVD SUITE 202
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City | TUKWILA
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State | WA
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Zip | 98188-2935
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Country | US
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Telephone | 206-575-4396
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Fax | 206-575-8615
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES C SIMMOMS
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Credential | OD
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Telephone | 206-575-4396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD00002097
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License Number State | WA
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