npidexNPI registry + Medicare data

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Preferred Provider Organization · OTHELLO, WA

Organization Active NPI 1134504145

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Preferred Provider Organization305R00000X✓MA 00011423WA

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.