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General NPI Number Information
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NPI Number | 1932448263
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Entity Type | Organization
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Legal Business Name | CASCADE CYTOLOGY REFERENCE
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 1225 NE 2ND AVE
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City | PORTLAND
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State | OR
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Zip | 97232-2003
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Country | US
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Telephone | 503-413-5051
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Fax | 503-413-5054
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Provider Business Mailing Address
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Address Line | PO BOX 4207
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City | PORTLAND
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State | OR
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Zip | 97208-4207
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Country | US
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Telephone | 503-268-4850
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Fax | 503-268-4801
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Authorized Official
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Title or Position | CFO
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Name | MICHEAL GRATTENDICK
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Credential |
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Telephone | 561-514-5822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 38D0623584
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License Number State | OR
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