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General NPI Number Information
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NPI Number | 1487766457
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Entity Type | Individual
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Provider Name | BENJAMIN E SIAPCO CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 2100 LITTLE MOUNTAIN LN
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City | MOUNT VERNON
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State | WA
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Zip | 98274-8752
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Country | US
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Telephone | 360-416-6735
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Fax | 360-424-6924
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Provider Business Mailing Address
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Address Line | PO BOX 97115
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City | LAKEWOOD
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State | WA
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Zip | 98497-0115
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Country | US
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Telephone | 253-588-7911
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Fax | 253-984-6774
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN00156113
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License Number State | WA
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