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General NPI Number Information
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NPI Number | 1912092628
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Entity Type | Individual
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Provider Name | ELIZABETH BECK WILSON-FOWLER SLP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1101 8TH ST STE B
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City | ANACORTES
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State | WA
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Zip | 98221-1800
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Country | US
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Telephone | 360-299-0331
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Fax | 360-299-0336
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Provider Business Mailing Address
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Address Line | PO BOX 11009
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City | OLYMPIA
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State | WA
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Zip | 98508-1009
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Country | US
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Telephone | 360-352-2037
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Fax | 360-352-0637
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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 | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | LL3965
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License Number State | WA
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