Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | MD09390 | OR |
NPI | 1114920055 |
---|---|
Provider Name | Dr. Wilfred Arthur Geschke |
First Address | Portland, OR 97216-2455 |
Second Address | Portland, OR 97216-2455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 19/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
072744 | (05) | OR |
1002793 | (05) | WA |
C92707 | (02) | OR |