Active NPI
Deeanna Keith, LMP
- Specialist
- Buckley, WA
National Provider Identifier
1306013271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00020351
- Practice address
- 10511B 224TH Ave E
Buckley, WA 98321-9251 - Phone
- (253) 334-7847
- Fax
- (253) 299-6205
- NPI assigned
- May 10, 2008
- Last updated
- May 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA00020351 | WA | Primary |
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
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00020351 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210377600000",
"number": "1306013271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10511B 224TH AVE E",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "983219251",
"telephone_number": "253-334-7847",
"fax_number": "253-299-6205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10511B 224TH AVE E",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "983219251",
"telephone_number": "253-334-7847",
"fax_number": "253-299-6205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEITH",
"first_name": "DEEANNA",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-10",
"last_updated": "2008-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00020351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buckley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.