=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881754539
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINDA M GEERE MD PS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2006
-----------------------------------------------------
Last Update Date | 04/24/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4300 TALBOT RD S STE 103
-----------------------------------------------------
City | RENTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98055-6238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-572-5112
-----------------------------------------------------
Fax | 425-572-6610
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4300 TALBOT RD S 103
-----------------------------------------------------
City | RENTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98055-6238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-572-5112
-----------------------------------------------------
Fax | 425-572-6610
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. LINDA MAGDALENE GEERE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 425-572-5112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD00025883
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------