Basic Information
Provider Information
NPI: 1720505316
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEER
FirstName: ADAM
MiddleName: CLAYTON
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 325 E PIONEER
Address2:  
City: PUYALLUP
State: WA
PostalCode: 983723265
CountryCode: US
TelephoneNumber: 2536978400
FaxNumber: 2536973730
Practice Location
Address1: 325 E PIONEER
Address2:  
City: PUYALLUP
State: WA
PostalCode: 983723265
CountryCode: US
TelephoneNumber: (253) 697-8400
FaxNumber: 2536973730
Other Information
ProviderEnumerationDate: 08/24/2017
LastUpdateDate: 08/24/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XCG60785499WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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