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General NPI Number Information
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NPI Number | 1932227154
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Entity Type | Organization
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Legal Business Name | SAN JUANS VISION CARE P.S.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 01/09/2015
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Provider Practice Location Address
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Address Line | 1286 SUITE 106 B MT BAKER ROAD
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City | EASTSOUND
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State | WA
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Zip | 98245
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Country | US
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Telephone | 360-376-5310
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Fax | 866-393-7127
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Provider Business Mailing Address
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Address Line | PO BOX 181
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City | EASTSOUND
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State | WA
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Zip | 98245
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Country | US
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Telephone | 360-376-5310
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Fax | 866-393-7127
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER T WHITE
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Credential | OD
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Telephone | 360-376-5310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OD00001839
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License Number State | WA
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