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General NPI Number Information
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NPI Number | 1518385285
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Entity Type | Individual
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Provider Name | ANTHONY MAIOLINO DPM, MPH
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Gender | Male
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 203 SE PARK PLAZA DR STE 140
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City | VANCOUVER
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State | WA
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Zip | 98684-5887
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Country | US
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Telephone | 971-219-2143
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Fax |
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Provider Business Mailing Address
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Address Line | 203 SE PARK PLAZA DR STE 140
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City | VANCOUVER
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State | WA
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Zip | 98684-5887
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Country | US
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Telephone | 503-813-2000
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP194714
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO60747031
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License Number State | WA
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