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General NPI Number Information
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NPI Number | 1659463511
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Entity Type | Individual
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Provider Name | KIM L BUI MD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 1003 PROVIDENCE DRIVE SUITE 210
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City | NEWBERG
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State | OR
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Zip | 97132
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Country | US
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Telephone | 503-537-5900
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Fax | 503-537-5959
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Provider Business Mailing Address
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Address Line | PO BOX 4949
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City | PORTLAND
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State | OR
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Zip | 97208-4949
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Country | US
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Telephone | 503-215-6446
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Fax | 503-215-6644
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD22943
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License Number State | OR
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