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General NPI Number Information
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NPI Number | 1649881483
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Entity Type | Organization
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Legal Business Name | TRUE DIAGNOSTICS
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 1122 NE 122ND AVE STE B-102
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City | PORTLAND
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State | OR
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Zip | 97230-2081
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Country | US
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Telephone | 971-266-8989
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Fax |
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Provider Business Mailing Address
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Address Line | 1122 NE 122ND AVE STE A200
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City | PORTLAND
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State | OR
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Zip | 97230-2083
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Country | US
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Telephone | 971-266-8989
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN LYONS
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Credential |
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Telephone | 360-970-7272
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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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