Provider Demographics
NPI:1740219906
Name:FINCH, JOHN GEOFFREY (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:GEOFFREY
Last Name:FINCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 NE 150TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7221
Mailing Address - Country:US
Mailing Address - Phone:206-363-5353
Mailing Address - Fax:206-363-7335
Practice Address - Street 1:1507 NE 150TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-7221
Practice Address - Country:US
Practice Address - Phone:206-363-5353
Practice Address - Fax:206-363-7335
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00000673208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1056902Medicaid
WA1056902Medicaid
WAG000101601Medicare PIN