Provider Demographics
NPI:1548304033
Name:GERRARDA C. O'BEIRNE
Entity type:Organization
Organization Name:GERRARDA C. O'BEIRNE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GERRARDA
Authorized Official - Middle Name:CONCEPTA
Authorized Official - Last Name:O'BEIRNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:206-628-0404
Mailing Address - Street 1:720 OLIVE WAY
Mailing Address - Street 2:SUITE 810
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1878
Mailing Address - Country:US
Mailing Address - Phone:206-628-0404
Mailing Address - Fax:206-628-0024
Practice Address - Street 1:720 OLIVE WAY
Practice Address - Street 2:SUITE 810
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1878
Practice Address - Country:US
Practice Address - Phone:206-628-0404
Practice Address - Fax:206-628-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA73331223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty