Healthcare Provider Details

I. General information

NPI: 1932300753
Provider Name (Legal Business Name): ANNE C. GEIL LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNE C. BUJACICH LMP

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18021 15TH AVE NE 106
SHORELINE WA
98155-3809
US

IV. Provider business mailing address

PO BOX 55267
SHORELINE WA
98155-0267
US

V. Phone/Fax

Practice location:
  • Phone: 206-365-0110
  • Fax: 206-365-1920
Mailing address:
  • Phone: 206-365-0110
  • Fax: 206-365-1920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA6008
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: