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NPI Code Detail

MEDICARE: KIMBERLY ADELL GECK LMT

MEDICARE: KIMBERLY ADELL GECK LMT
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
1171W00000XContractor15544OR

General Provider Information

NPI Number : 1235495938
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ADELL GECK LMT
Provider Business Mailing Address
First Line : 1575 CANARY CT NE
Second Line :
City : SALEM
State : OR
Zip : 97301-1989
Country : US
Telephone Number : 503-910-4453
Fax Number :
Provider Business Practice Location Address
First Line : 4132 DEVONSHIRE CT NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1982
Country : US
Telephone Number : 503-910-4453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2012
Last Update Date : 04/06/2012

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Directions to “ KIMBERLY ADELL GECK LMT” Practice Location

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