Provider Demographics
NPI:1275703118
Name:PEREZ-BARON, GINA (MD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:PEREZ-BARON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S DIRECTOR ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-4514
Mailing Address - Country:US
Mailing Address - Phone:415-309-6466
Mailing Address - Fax:
Practice Address - Street 1:520 S DIRECTOR ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-4514
Practice Address - Country:US
Practice Address - Phone:415-309-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0172207Q00000X
CAA102973207Q00000X
WAMD60956309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine