Karen Ackerman, M.D.
Individual provider Active NPI Diagnostic Radiology Physician · Tacoma, WA
NPI 1164574554 · NPPES record last updated Mar 31, 2021
Key facts
- NPI
- 1164574554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- MD00037898 (WA)
- Practice address
- 209 Martin Luther King Jr Way
Tacoma, WA 98405-4265 - Phone
- (253) 596-3300
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
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 |
|---|---|---|---|---|
| I20080212000588 | WA | Practitioner - Diagnostic Radiology | 2466535521 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00037898 | WA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current |
Accepting new patients |
Locations
14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409
3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000
19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD00037898 | WA | Yes |
Addresses
Primary practice location
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Mailing address
PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8249237 | Medicaid | WA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Other providers in Tacoma, WA
- Carmen A Acfalle
- Achieve Rehabilitation, Inc.
- Achieve Wa LLC
- Hailun Achtelstetter
- Stephanie P Acierno
- Laci Leigh Ackerman
- Aida Jaqueline Acosta Quintana
- Diane Acosta
- Acrobat Doc PLLC
- Action Association Counseling Services
All providers in Tacoma, WA · Diagnostic Radiology 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 Mar 31, 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.