Basic Information
Provider Information
NPI: 1891284121
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: GEOFFREY
MiddleName: ROGER
NamePrefix:  
NameSuffix:  
Credential: MBCHB, MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 50095
Address2:  
City: SEATTLE
State: WA
PostalCode: 981455095
CountryCode: US
TelephoneNumber: 2065205700
FaxNumber:  
Practice Location
Address1: 825 EASTLAKE AVE E
Address2:  
City: SEATTLE
State: WA
PostalCode: 981094405
CountryCode: US
TelephoneNumber: 2066061024
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/02/2018
LastUpdateDate: 05/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0000XTR60851790WAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology

No ID Information.


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