ProviderBusinessMailingAddressFaxNumber = '3606041755'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1730380072
HICKS
KEVIN
SPENCER
700 NE 87TH AVE
VANCOUVER
WA
986641913
1083998777
WAN
ALISON
M
700 NE 87TH AVE
VANCOUVER
WA
986641913
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