Provider Demographics
NPI:1942229208
Name:LONGO, GINGER K (MD)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:K
Last Name:LONGO
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 1:611 SOUTH CHESTNUT
Mailing Address - Street 2:SUITE D
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926
Mailing Address - Country:US
Mailing Address - Phone:509-933-8700
Mailing Address - Fax:509-933-8705
Practice Address - Street 1:611 SOUTH CHESTNUT
Practice Address - Street 2:SUITE D
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926
Practice Address - Country:US
Practice Address - Phone:509-933-8700
Practice Address - Fax:509-933-8705
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0800207V00000X
WAMD00047396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology