Provider Demographics
NPI:1629245402
Name:O KEEFFE, GEMMA C (MD)
Entity Type:Individual
Prefix:
First Name:GEMMA
Middle Name:C
Last Name:O KEEFFE
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 1:934 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-2957
Mailing Address - Country:US
Mailing Address - Phone:360-385-5330
Mailing Address - Fax:360-385-0206
Practice Address - Street 1:934 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-2957
Practice Address - Country:US
Practice Address - Phone:360-385-5330
Practice Address - Fax:360-385-0206
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60140058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine