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NPI 1891036935

NPI 1891036935 : TAYLOR NICOLE DODD LMT : ARLINGTON, WA

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General NPI Number Information
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    NPI Number           |    1891036935
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    Entity Type          |    Individual 
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    Provider Name        |    TAYLOR NICOLE DODD LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/14/2013
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    Last Update Date     |    10/23/2017
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Provider Practice Location Address
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    Address Line         |    16404 SMOKEY POINT BLVD SUITE 307
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    City                 |    ARLINGTON
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    State                |    WA
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    Zip                  |    98223
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    Country              |    US
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    Telephone            |    360-653-0950
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    Fax                  |    360-653-9887
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Provider Business Mailing Address
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    Address Line         |    16404 SMOKEY POINT BLVD SUITE 307
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    City                 |    ARLINGTON
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    State                |    WA
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    Zip                  |    98223
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    Country              |    US
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    Telephone            |    360-653-0950
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    Fax                  |    360-653-9887
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MA60324966
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    License Number State |    WA
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