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General NPI Number Information
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NPI Number | 1659603744
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Entity Type | Organization
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Legal Business Name | CERESCAN CORP
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 1015 8TH AVE N
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City | SEATTLE
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State | WA
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Zip | 98109-3504
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Country | US
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Telephone | 720-242-9081
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Fax | 866-433-3965
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Provider Business Mailing Address
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Address Line | 990 S LOGAN ST
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City | DENVER
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State | CO
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Zip | 80209-4130
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Country | US
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Telephone | 720-242-9081
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Fax | 866-433-3965
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Authorized Official
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Title or Position | CEO
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Name | JOHN KELLEY
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Credential |
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Telephone | 720-242-9081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | WN-M0304-1
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License Number State | WA
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