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General NPI Number Information
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NPI Number | 1912663253
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Entity Type | Individual
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Provider Name | VINICIO VIQUEZ
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Gender | Male
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 1520 23RD AVE RM 7
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City | SEATTLE
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State | WA
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Zip | 98122-2919
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Country | US
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Telephone | 617-694-6006
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Fax | --
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Provider Business Mailing Address
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Address Line | 1520 23RD AVE RM 7
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City | SEATTLE
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State | WA
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Zip | 98122-2919
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Country | US
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Telephone | 617-694-6006
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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 | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number | CL1278006
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License Number State | FL
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