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General NPI Number Information
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NPI Number | 1851024954
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Entity Type | Organization
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Legal Business Name | PERMANENTE HEALTH CARE VENTURES, PC
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 401 NE 19TH AVE STE 200
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City | PORTLAND
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State | OR
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Zip | 97232-4800
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Country | US
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Telephone | 503-917-0685
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Fax |
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Provider Business Mailing Address
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Address Line | 500 NE MULTNOMAH ST STE 100
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City | PORTLAND
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State | OR
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Zip | 97232-2031
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Country | US
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Telephone | 503-917-0685
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICAH L THORP
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Credential | DO
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Telephone | 503-329-9894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2279P1005X
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Taxonomy Name | Pulmonary Rehabilitation Registered Respiratory Therapist
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License Number |
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License Number State |
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