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General NPI Number Information
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NPI Number | 1861073058
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Entity Type | Organization
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Legal Business Name | CLINICOPS, LLC
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 374 OWENS ST SE
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City | SALEM
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State | OR
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Zip | 97302-4183
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Country | US
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Telephone | 866-972-0235
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Fax |
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Provider Business Mailing Address
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Address Line | 2459 SE TUALATIN VALLEY HWY # 416
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City | HILLSBORO
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State | OR
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Zip | 97123-7919
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Country | US
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Telephone | 503-972-0235
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Fax |
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Authorized Official
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Title or Position | BILLING ADMINISTRATOR
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Name | JACQUELINE MORRISON NELSON
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Credential |
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Telephone | 503-972-0235
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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