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NPI Code Detail

MEDICARE: DR. GENJI C KITAGAWA DO

MEDICARE: DR. GENJI C KITAGAWA DO
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
1208800000XUrology PhysicianOP00001984WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AB32999OTHERWAMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093703191
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GENJI C KITAGAWA DO
Provider Business Mailing Address
First Line : PO BOX 421
Second Line :
City : LIBERTY LAKE
State : WA
Zip : 99019-0421
Country : US
Telephone Number : 866-747-2455
Fax Number : 509-944-9644
Provider Business Practice Location Address
First Line : 1200 E COLUMBIA AVE
Second Line :
City : COLVILLE
State : WA
Zip : 99114-3354
Country : US
Telephone Number : 509-684-3701
Fax Number : 509-684-5817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 06/16/2021

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1548258643 — MRS. BERNEAL E. BUNDY RN CRNFA
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1275521379 — DR. BERNARD E CURRIGAN DO
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1174511208 — DR. LESLIE E WATERS MD
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1730177841 — MRS. BARBARA A WOS ELLEDGE ARNP FNP
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1467440578 — DR. PATRICK A BARKER MD
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Directions to “ DR. GENJI C KITAGAWA DO” Practice Location

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