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General NPI Number Information
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NPI Number | 1598633984
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Entity Type | Individual
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Provider Name | MITCHELL MAYES
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Gender | Male
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 15203 NE 72ND AVE
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City | VANCOUVER
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State | WA
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Zip | 98686-1929
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Country | US
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Telephone | 360-209-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 15203 NE 72ND AVE
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City | VANCOUVER
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State | WA
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Zip | 98686-1929
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Country | US
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Telephone | 419-956-2151
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10044091
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License Number State | OR
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