Provider Demographics
NPI:1386619088
Name:GEELAN, KIM M (MD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:M
Last Name:GEELAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 35147
Mailing Address - Street 2:#1801
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5147
Mailing Address - Country:US
Mailing Address - Phone:503-299-9906
Mailing Address - Fax:503-225-9002
Practice Address - Street 1:707 SW WASHINGTON ST
Practice Address - Street 2:SUITE 700
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3536
Practice Address - Country:US
Practice Address - Phone:503-299-9906
Practice Address - Fax:503-225-9002
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2018-10-12
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Provider Licenses
StateLicense IDTaxonomies
ORMD17215207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR050040826OtherRR MEDICARE
CAXPY195518Medicaid
OR070052Medicaid
WA8170250Medicaid
F97434Medicare UPIN
CAXPY195518Medicaid