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General NPI Number Information
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NPI Number | 1669422416
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Entity Type | Individual
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Provider Name | JAMES J HASENAUER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 545 NE 47TH AVE STE 215
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City | PORTLAND
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State | OR
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Zip | 97213-2237
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Country | US
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Telephone | 503-731-2900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4000-21
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City | PORTLAND
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State | OR
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Zip | 97213
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Country | US
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Telephone | 949-263-8620
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Fax | 949-263-1639
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A89001
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD27906
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License Number State | OR
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