Genesis Obstetrics and Gynecology PLLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

OP00001459 Issued in WA

Legal business name

GENESIS OBSTETRICS AND GYNECOLOGY PLLC

Practice address

314 Martin Luther King Jr Way
Suite 401
Tacoma, WA 98405-4250

Phone

(253) 460-7777

NPI assigned

May 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Johnette B Maehren, D.O.

Title

Owner

Phone

(253) 460-7777

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972713055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 MARTIN LUTHER KING JR WAY",
            "address_2": "SUITE 401",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054250",
            "telephone_number": "253-460-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MARTIN LUTHER KING JR WAY",
            "address_2": "SUITE 401",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054250",
            "telephone_number": "253-460-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS OBSTETRICS AND GYNECOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAEHREN",
        "authorized_official_first_name": "JOHNETTE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-460-7777",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WA",
            "license": "OP00001459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha O Gelperin
• Sarah Jean Gemmell, DA
• Eileen Gendreau
• Julian L Gendreau, MD
• Genesis Medical Spa
• Genesis Rehab Services
• Damian Patrick Gennette, MDIV
• Genoa Healthcare LLC (Genoa Healthcare)
• Haley E Genster, RBT
• Gentiva Health Services (USA), Inc. (Kindred at Home)

• Gynecology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Gynecology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.