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Geoffrey Owen Mcnicoll, MD
Family Medicine Physician in Puyallup, Washington
NPI 1255438586

Geoffrey Owen Mcnicoll is a Family Medicine Physician based in Puyallup, WA. Geoffrey Owen Mcnicoll practices in Puyallup, WA and has the professional credentials of MD. The NPI Number for Geoffrey Owen Mcnicoll is 1255438586 and holds a License No. EC081117 (Washington).

The current practice location address for Geoffrey Owen Mcnicoll is 15214 Canyon Rd E, Puyallup, WA and can be reached out via phone at 253-539-4200 and via fax at 253-539-6005.

Location: 15214 Canyon Rd E, Puyallup, WA, 98375-7472
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255438586
Provider Name
Geoffrey Owen Mcnicoll
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
15214 Canyon Rd E, Puyallup, WA, 98375-7472
Phone Number
253-539-4200
Fax Number
253-539-6005
Provider Enumeration Date
09/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0273458 01 WA STATE L&I
0273460 01 WA STATE L&I
institution
Provider Business Practice Location Address Details
Address
15214 Canyon Rd E
City
Puyallup
State
Washington
Zip
98375-7472
Phone Number
253-539-4200
Fax Number
253-539-6005
person
Provider Business Mailing Address Details
Address
15214 Canyon Rd E
City
Puyallup
State
Washington
Zip
98375-7472
Phone Number
253-539-4200
Fax Number
253-539-6005
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
MD60180279 (Washington)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
EC081117 (Maine)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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