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NPI Code Detail

MEDICARE: KJERSTEN GMEINER M.D.

MEDICARE: KJERSTEN GMEINER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianC53440CA
2207Q00000XFamily Medicine PhysicianMD00039154WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1332441OTHERWASTATE L&I
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922151612
Entity Type Code : Individual
Provider Name (Legal Business Name) : KJERSTEN GMEINER M.D.
Provider Business Mailing Address
First Line : 10030 SW 210TH ST
Second Line :
City : VASHON
State : WA
Zip : 98070-6584
Country : US
Telephone Number : 206-463-3671
Fax Number : 206-463-3613
Provider Business Practice Location Address
First Line : 10030 SW 210TH ST
Second Line :
City : VASHON
State : WA
Zip : 98070-6584
Country : US
Telephone Number : 206-463-3671
Fax Number : 206-463-3613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 12/19/2014

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