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General NPI Number Information
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NPI Number | 1700595949
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Entity Type | Organization
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Legal Business Name | SEEDED SOMATICS LLC
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 5263 NE 32ND PL
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City | PORTLAND
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State | OR
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Zip | 97211-6915
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Country | US
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Telephone | 971-940-3634
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Fax |
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Provider Business Mailing Address
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Address Line | 5263 NE 32ND PL
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City | PORTLAND
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State | OR
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Zip | 97211-6915
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. OBI SCHLACHTER
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Credential | MA, CDACI, LPC-ASSOC
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Telephone | 971-940-3634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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