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General NPI Number Information
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NPI Number | 1669427043
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Entity Type | Organization
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Legal Business Name | VANCOUVER EYE CARE PS
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 17720 SE MILL PLAIN SUITE 100
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 360-823-2018
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Fax | 360-823-2022
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Provider Business Mailing Address
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Address Line | PO BOX 61896
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City | VANCOUVER
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State | WA
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Zip | 98666
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Country | US
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Telephone | 360-696-2081
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Fax | 360-823-2260
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PAMELA J HUFFMAN
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Credential |
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Telephone | 360-823-2012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | PENDING
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License Number State | WA
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