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General NPI Number Information
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NPI Number | 1821503418
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Entity Type | Organization
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Legal Business Name | COMPASS FAMILY MEDICINE
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 1215 C ST
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City | HOOD RIVER
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State | OR
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Zip | 97031-1659
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Country | US
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Telephone | 541-436-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 1215 C ST
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City | HOOD RIVER
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State | OR
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Zip | 97031-1659
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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 | PRACTICE MANAGER
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Name | STEPHANIE PATE
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Credential |
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Telephone | 541-340-9607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | PA150149
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License Number State | OR
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