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General NPI Number Information
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NPI Number | 1932067600
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Entity Type | Organization
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Legal Business Name | WESTERN ROOTS HEALTHCARE, LLC
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 14899 SW CULVER HWY
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City | CULVER
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State | OR
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Zip | 97734-7014
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Country | US
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Telephone | 541-920-0727
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Fax | 541-325-4312
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Provider Business Mailing Address
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Address Line | 14899 SW CULVER HWY
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City | CULVER
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State | OR
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Zip | 97734-7014
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Country | US
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Telephone | 541-920-0727
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Fax | 541-325-4312
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | AMY JORDAN
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Credential | NP
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Telephone | 541-279-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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