Provider Demographics
NPI:1821145657
Name:GEAGAN, KEVIN SHAUN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:SHAUN
Last Name:GEAGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 S BURLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-1708
Mailing Address - Country:US
Mailing Address - Phone:360-755-1414
Mailing Address - Fax:360-755-0172
Practice Address - Street 1:249 S BURLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-1708
Practice Address - Country:US
Practice Address - Phone:360-755-1414
Practice Address - Fax:360-755-0172
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3117111N00000X
CA18805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor