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General NPI Number Information
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NPI Number | 1578329843
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Entity Type | Organization
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Legal Business Name | EVOKE THERAPY LLC
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 5441 S MACADAM AVE # 5083
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City | PORTLAND
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State | OR
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Zip | 97239-6106
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Country | US
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Telephone | 541-357-6063
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Fax |
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Provider Business Mailing Address
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Address Line | 16250 HOMECOMING DR UNIT 1767
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City | CHINO
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State | CA
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Zip | 91708-8862
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Country | US
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Telephone | 215-930-4478
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELA MURRIETA
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Credential |
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Telephone | 215-930-4478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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