Provider Demographics
NPI:1942482039
Name:DR. SUSANNE L. GEE & CO., PLLC
Entity Type:Organization
Organization Name:DR. SUSANNE L. GEE & CO., PLLC
Other - Org Name:SKIN DOC SHOP
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:LORAINE
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-932-3884
Mailing Address - Street 1:4744 41ST AVE SW
Mailing Address - Street 2:SUITE #104
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4570
Mailing Address - Country:US
Mailing Address - Phone:206-932-3884
Mailing Address - Fax:206-932-3885
Practice Address - Street 1:4744 41ST AVE SW
Practice Address - Street 2:SUITE #104
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4570
Practice Address - Country:US
Practice Address - Phone:206-932-3884
Practice Address - Fax:206-932-3885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA36781261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB28061Medicare PIN