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NPI Code Detail

MEDICARE: EMILY GEAN

MEDICARE: EMILY GEAN
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1912300468
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY GEAN
Provider Business Mailing Address
First Line : 9901 NE 7TH AVE
Second Line : SUITE C-116
City : VANCOUVER
State : WA
Zip : 98685-4523
Country : US
Telephone Number : 360-571-2453
Fax Number : 360-573-0404
Provider Business Practice Location Address
First Line : 6200 SW ARCTIC DR
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-9447
Country : US
Telephone Number : 312-965-2997
Fax Number : 312-929-0324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2014
Last Update Date : 09/19/2023

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Directions to “ EMILY GEAN ” Practice Location

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