Individual
KOENRAAD DE GEEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MC:L466, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-4473
Mailing address
3181 SW SAM JACKSON PARK RD, MC:L466, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-4473
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD162819
OR
207VX0201X
Gynecologic Oncology Physician
35280
IA
207VX0201X
Gynecologic Oncology Physician
Primary
MD162819
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0422592
—
IA
01
—
35627
WELLMARK BCBS
IA
Enumeration date
10/05/2005
Last updated
03/20/2019
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