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General NPI Number Information
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NPI Number | 1972757870
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PROFESSIONAL SERVICES
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 3101 E STATE ST STE 2107
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City | EAGLE
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State | ID
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Zip | 83616-6232
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Country | US
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Telephone | 208-473-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 SW 5TH AVE
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City | PORTLAND
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State | OR
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Zip | 97201-5537
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Country | US
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Telephone | 503-494-4745
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Fax |
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Authorized Official
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Title or Position | VP/ENTERPRISE REVENUE CYCLE
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Name | KELLY ANNE SMITH
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Credential |
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Telephone | 503-494-4422
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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 |
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License Number State |
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