Provider Demographics
NPI:1881754539
Name:LINDA M GEERE MD PS INC
Entity type:Organization
Organization Name:LINDA M GEERE MD PS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MAGDALENE
Authorized Official - Last Name:GEERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-572-5112
Mailing Address - Street 1:4300 TALBOT RD S
Mailing Address - Street 2:103
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6238
Mailing Address - Country:US
Mailing Address - Phone:425-572-5112
Mailing Address - Fax:425-572-6610
Practice Address - Street 1:4300 TALBOT RD S
Practice Address - Street 2:STE 103
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6238
Practice Address - Country:US
Practice Address - Phone:425-572-5112
Practice Address - Fax:425-572-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1050715Medicaid
193301OtherL & I
GE7866OtherREGENCE
E57891Medicare UPIN
8852567Medicare ID - Type Unspecified