De Geest, Koenraad

De Geest, Koenraad is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Mc:L466, Portland OR 97239-3011. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecologic Oncology, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Gynecologic Oncology is his primary health care specialty. De Geest, Koenraad can be contacted via phone (503) 418-4500.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Mc:L466 Portland OR 97239-3011
Phone: (503) 418-4500
Fax: (503) 494-4473
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecologic Oncology 207VX0201X 35280 Iowa
Allopathic & Osteopathic Physicians / Gynecologic Oncology 207VX0201X MD162819 Oregon
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD162819 Oregon

Profile Details

NPI number 1093702862
LBN Legal business name De Geest, Koenraad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Mar 20th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093702862 NPPES
Iowa Other 35627 WELLMARK BCBS
Iowa MEDICAID 0422592 WELLMARK BCBS

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