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General NPI Number Information
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NPI Number | 1609837574
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Entity Type | Organization
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Legal Business Name | OREGON HEALTH & SCIENCE UNIVERSITY
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 2730 SW MOODY AVE SD-PATH
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City | PORTLAND
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State | OR
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Zip | 97201-5042
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Country | US
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Telephone | 503-494-8904
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10076
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City | VAN NUYS
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State | CA
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Zip | 91410-0076
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Country | US
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Telephone | 805-578-8300
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Fax | 805-578-8950
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY STEWART
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Credential | DDS
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Telephone | 503-494-8904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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