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General NPI Number Information
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NPI Number | 1972584449
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Entity Type | Individual
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Provider Name | KAREN L FONG DC, LAC
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Gender | Female
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10360 NE WASCO ST
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City | PORTLAND
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State | OR
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Zip | 97220-3927
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Country | US
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Telephone | 503-252-8125
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Fax |
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Provider Business Mailing Address
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Address Line | 5919 N BURRAGE AVE
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City | PORTLAND
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State | OR
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Zip | 97217-4137
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Country | US
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Telephone | 503-254-5109
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 272702
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC00220
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License Number State | OR
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