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General NPI Number Information
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NPI Number | 1578299772
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Entity Type | Individual
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Provider Name | SAMANTHA JO SANTIAGO FNP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 9800 SE SUNNYSIDE RD
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City | CLACKAMAS
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State | OR
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Zip | 97015-9750
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Country | US
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Telephone | 800-813-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 500 NE MULTNOMAH ST STE 100
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City | PORTLAND
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State | OR
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Zip | 97232-2031
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Country | US
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Telephone | 800-813-2000
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Fax | 855-524-5255
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 201391395RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 202207379NP-PP
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License Number State | OR
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