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General NPI Number Information
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NPI Number | 1912980624
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Entity Type | Individual
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Provider Name | JEFFREY WAYNE GERTNER MD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 21800 MARKET PL NW STE 103
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City | POULSBO
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State | WA
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Zip | 98370-6667
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Country | US
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Telephone | 360-291-5700
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Fax | 360-637-0863
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Provider Business Mailing Address
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Address Line | 21800 MARKET PL NW STE 103
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City | POULSBO
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State | WA
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Zip | 98370-6667
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Country | US
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Telephone | 360-291-5700
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Fax | 360-637-0863
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD61659432
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License Number State | WA
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