Keanna G Worthy, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OL70024377 Issued in WA

Practice address

1322 3Rd St SE Ste 240
Puyallup, WA 98372-3771

Phone

(253) 697-1420

NPI assigned

May 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Keanna Gloria Worthy Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1124684451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 MCNEIL ST",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983278779",
            "telephone_number": "253-697-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 3RD ST SE STE 240",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723771",
            "telephone_number": "253-697-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHY",
        "first_name": "KEANNA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MO",
            "license": "RBT-18-70458",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL70024377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEANNA",
            "last_name": "WORTHY",
            "middle_name": "GLORIA",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret A Woods
• Mikayla Rachelle Woolley, MOT, OTR/L
• Anna Kali Worden, ARNP
• Kayleigh Worek
• Bruce Micheal Worthen, D.P.M.
• Joanne-Ritzelle Castillo Woskov, PHARMD
• Elizabeth Wozniak
• Holly Wozniak, ARNP
• Deletha Rae Wright, LMT
• Irena Alexandra Wright, ARNP

• Family Medicine Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.