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General NPI Number Information
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NPI Number | 1912572157
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Entity Type | Individual
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Provider Name | GARTH ALAN WEST DPT
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Gender | Male
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 3615 SPICER DR SE
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City | ALBANY
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State | OR
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Zip | 97322-7043
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Country | US
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Telephone | 541-967-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 700 NW 5TH ST APT 22
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City | CORVALLIS
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State | OR
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Zip | 97330-6474
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Country | US
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Telephone | 406-407-4808
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 64097
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License Number State | OR
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