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General NPI Number Information
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NPI Number | 1477704070
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Entity Type | Organization
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Legal Business Name | LJC & COMPANY HEALTHCARE, LLC
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 1675 SW MARLOW AVENUE SUITE 405
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City | PORTLAND
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State | OR
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Zip | 97225
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Country | US
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Telephone | 503-620-6011
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Fax | 503-620-6199
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Provider Business Mailing Address
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Address Line | 1675 SW MARLOW AVENUE SUITE 405
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City | PORTLAND
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State | OR
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Zip | 97225
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Country | US
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Telephone | 503-620-6011
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Fax | 503-620-6199
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Authorized Official
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Title or Position | OWNER
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Name | MS. LORI JO CALDER-MILLER
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Credential | RN
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Telephone | 503-620-6011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 13-1399
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License Number State | OR
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