Katherine Kenningham, MD
Individual provider Active NPI Neonatal-Perinatal Medicine Physician · Tacoma, WA
NPI 1043586969 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1043586969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal-Perinatal Medicine Physician 2080N0001X
- License
- MD60564662 (WA)
- Practice address
- 315 Martin Luther King Jr Way
Tacoma, WA 98405-4234 - Phone
- (253) 403-1000
- NPI assigned
- Mar 26, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150714003265 | WA | Practitioner - Pediatric Medicine | 4385957737 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60292818 | WA | MD | Pediatrics Physician |
| MD 60564662 | WA | MD | Pediatrics Physician |
| MD60564662 | WA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seattle Children'S Hospital | Current | Accepting new patients | |
| Seattle Childrens Hospital | Current |
Accepting new patients | |
| Multicare Health System | Past | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients |
Locations
1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141
8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700
4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000
4800 Sand Point Way NE
#7520
Seattle, WA 98105
Phone (206) 987-2599
1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD 60564662 | WA | |
| Pediatrics Physician | 208000000X | 60292818 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD60564662 | WA | Yes |
Addresses
Primary practice location
315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Mailing address
4909 42ND Ave NW
Gig Harbor, WA 98335-8160
Phone (206) 854-7350
Other providers in Tacoma, WA
- Catherine Marie Kenner
- Kenneth C. Dahlin, O.D., PLLC
- Kenneth J Ritter MD PLLC
- James Francis Kenney
- Lisa Kenney
- Stephanie Ida Kennison
- Calvin Eugene Kennon II
- Angela Yurie Kenny
- Coeleen Kent-Wilson
- Jennifer Anne Kent
All providers in Tacoma, WA · Neonatal-Perinatal Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.