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General NPI Number Information
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NPI Number | 1942987482
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Entity Type | Organization
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Legal Business Name | ASSURE PSYCHIATRY INC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 511 SW 10TH AVE STE 601
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City | PORTLAND
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State | OR
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Zip | 97205-2707
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Country | US
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Telephone | 971-244-8844
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Fax |
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Provider Business Mailing Address
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Address Line | 511 SW 10TH AVE STE 601
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City | PORTLAND
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State | OR
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Zip | 97205-2707
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Country | US
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Telephone | 971-244-8844
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Fax |
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Authorized Official
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Title or Position | NP
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Name | NJIDEKA DOMRUFUS
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Credential | APRN
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Telephone | 817-524-7107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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