Active NPI
Ray H. Krueger, M.D.
- Family Medicine Physician
- Tacoma, WA
National Provider Identifier
1063564441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00019732
- Practice address
- 9505 S Steele St
Tacoma, WA 98444-1858 - Phone
- (253) 597-6800
- NPI assigned
- Jan 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00019732 | WA | Primary |
Addresses
Primary practice location
9505 S Steele St
Tacoma, WA 98444-1858
Mailing address
PO Box 34581
Seattle, WA 98124-1581
Phone (509) 241-7349
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8586406 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00019732 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1063564441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34581",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241581",
"telephone_number": "509-241-7349",
"fax_number": "509-241-7628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9505 S STEELE ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984441858",
"telephone_number": "253-597-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "RAY",
"middle_name": "H.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-17",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00019732",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8586406",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.