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General NPI Number Information
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NPI Number | 1821472960
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Entity Type | Organization
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Legal Business Name | COMPLETE EYE CARE, INC.
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Dates
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Enumeration Date | 07/18/2015
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Last Update Date | 07/18/2015
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Provider Practice Location Address
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Address Line | 500 NW 20TH ST STE 100
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City | GRESHAM
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State | OR
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Zip | 97030-2442
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Country | US
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Telephone | 503-667-2020
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Fax | 503-667-6386
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Provider Business Mailing Address
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Address Line | 500 NW 20TH ST STE 100
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City | GRESHAM
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State | OR
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Zip | 97030-2442
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Country | US
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Telephone | 503-667-2020
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Fax | 503-667-6386
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Authorized Official
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Title or Position | SECRETARY
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Name | SHARON E NEAL
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Credential |
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Telephone | 503-667-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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