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General NPI Number Information
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NPI Number | 1396813937
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Entity Type | Organization
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Legal Business Name | JON F GEFFEN DO PC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 1515 MARTIN LUTHER KING JR WAY
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City | TACOMA
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State | WA
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Zip | 98405-3933
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Country | US
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Telephone | 253-572-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 MARTIN LUTHER KING JR WAY
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City | TACOMA
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State | WA
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Zip | 98405-3933
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Country | US
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Telephone | 253-572-2663
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Fax |
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | JON F GEFFEN
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Credential | DO
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Telephone | 253-572-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OP00001971
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License Number State | WA
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