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NPI 1912292434

NPI 1912292434 : ANA MELY LOPEZ : TOPPENISH, WA

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General NPI Number Information
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    NPI Number           |    1912292434
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    Entity Type          |    Individual 
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    Provider Name        |    ANA MELY LOPEZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/13/2011
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    Last Update Date     |    06/13/2011
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Provider Practice Location Address
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    Address Line         |    518 W 1ST AVE 
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    City                 |    TOPPENISH
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    State                |    WA
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    Zip                  |    98948-1564
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    Country              |    US
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    Telephone            |    509-865-6901
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    830 S LESTER RD 
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    City                 |    OUTLOOK
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    State                |    WA
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    Zip                  |    98938-9753
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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    |    
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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        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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