MEDICARE: FRANK G GLEESON MD PS INC

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1831350487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANK G GLEESON MD PS INC

Provider Business Mailing Address
First Line	:	3207 NE 125TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4516
Country	:	US
Telephone Number	:	206-367-5096
Fax Number	:	206-362-8002

Provider Business Practice Location Address
First Line	:	3207 NE 125TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4516
Country	:	US
Telephone Number	:	206-367-5096
Fax Number	:	206-362-8002

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FRANK G GLEESON
Credential	:	MD
Telephone Number	:	206-367-5096

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	06/17/2008

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