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General NPI Number Information
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NPI Number | 1609065176
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Entity Type | Organization
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Legal Business Name | THOMAS W. DODSON, MD PC
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Dates
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Enumeration Date | 10/19/2007
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 2187 SW MAIN ST SUITE 102
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City | PORTLAND
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State | OR
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Zip | 97205-1123
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Country | US
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Telephone | 503-228-0370
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Fax | 503-228-6690
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Provider Business Mailing Address
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Address Line | 2187 SW MAIN ST SUITE 102
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City | PORTLAND
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State | OR
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Zip | 97205-1123
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Country | US
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Telephone | 503-228-0370
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Fax | 503-228-6690
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS WILLIAM DODSON
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Credential | M.D.
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Telephone | 503-228-0370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 17869
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License Number State | OR
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