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General NPI Number Information
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NPI Number | 1932154366
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Entity Type | Individual
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Provider Name | MONICA FERGUSON FNP
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 511 MAIN ST SUITE 112
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City | OREGON CITY
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State | OR
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Zip | 97045-1830
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Country | US
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Telephone | 503-344-6717
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Fax | 503-345-9867
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Provider Business Mailing Address
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Address Line | PO BOX 945
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-0103
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Country | US
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Telephone | 503-344-6717
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Fax | 503-345-9867
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200650008NP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 200650008NP
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License Number State | OR
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