Deeanna Keith, LMP
Individual provider Active NPI Specialist · Buckley, WA
NPI 1306013271 · NPPES record last updated May 10, 2008
Key facts
- NPI
- 1306013271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MA00020351 (WA)
- Practice address
- 10511B 224TH Ave E
Buckley, WA 98321-9251 - Phone
- (253) 334-7847
- Fax
- (253) 299-6205
- NPI assigned
- May 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00020351 | WA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00020351 | WA | Yes |
Addresses
Primary practice location
10511B 224TH Ave E
Buckley, WA 98321-9251
Mailing address
10511B 224TH Ave E
Buckley, WA 98321-9251
Phone (253) 334-7847
Other providers in Buckley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.