Individual provider Active NPI

William Alexander Ketchum, MD

  • Surgery Physician
  • Tacoma, WA
National Provider Identifier
1063917631
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101276325 Issued in VA
Practice address
9040 Jackson Avenue
Tacoma, WA 98431-0001
Phone
(253) 968-2252
NPI assigned
Mar 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD61586721 WA
Surgery Physician 208600000X 0101276325 VA Primary

Addresses

Primary practice location

9040 Jackson Avenue
Tacoma, WA 98431-0001

Mailing address

9040 Jackson Avenue
Tacoma, WA 98431-0001
Phone (786) 973-7400

Other practice location 1

1802 Yakima Ave Ste 104
Tacoma, WA 98405-5303
Phone (253) 426-6272

Other practice location 2

4494 North Palmer Road
Bethesda, MD 20889-0001
Phone (786) 973-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009002925 WA Practitioner - General Surgery 5294232765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1802 Yakima Ave
Suite 104
Tacoma, WA 98405-5303
Phone (253) 426-6739

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101276325VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Sep 8, 2025 Accepting new patients
Franciscan Medical Group Surgery CurrentSince Sep 8, 2025 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1802 Yakima Ave
Ste 104
Tacoma, WA 98405
Phone (253) 426-6272

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1063917631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "786-973-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 Yakima Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984055303",
            "country_code": "US",
            "telephone_number": "253-426-6272",
            "fax_number": "253-426-4060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4494 North Palmer Road",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890001",
            "country_code": "US",
            "telephone_number": "786-973-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "WILLIAM",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61586721",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101276325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.