Provider Demographics
NPI:1932300753
Name:GEIL, ANNE C (LMP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:GEIL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:C
Other - Last Name:BUJACICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:PO BOX 55267
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-0267
Mailing Address - Country:US
Mailing Address - Phone:206-365-0110
Mailing Address - Fax:206-365-1920
Practice Address - Street 1:18021 15TH AVE NE
Practice Address - Street 2:106
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3809
Practice Address - Country:US
Practice Address - Phone:206-365-0110
Practice Address - Fax:206-365-1920
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA6008174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist