Mark Allen Keller, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD61049864 Issued in WA

Practice address

7205 265TH St NW
Stanwood, WA 98292-6221

Phone

(360) 629-1500

NPI assigned

Jul 3, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkeller69457@direct.tecmc.com

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.

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766

  Pediatrics

  Medicare reassignment NPD
• The Polyclinic PLLC

  dba Optum - Broadway

  • Audiologist
  • Seattle, WA
  • NPI 1174594634

  Pediatrics

  Medicare reassignment NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425

  Pediatrics

  NPD
• The Polyclinic

  • Radiation Oncology Physician
  • Seattle, WA
  • NPI 1962824219
  NPD
• The Polyclinic PLLC

  dba Optum Tacoma

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487
  NPD
• Optum Care Washington PLLC

  • Ambulatory Surgical Clinic/Center
  • Everett, WA
  • NPI 1154318103
  NPD (past)

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1497138861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 265TH ST NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926221",
            "telephone_number": "360-629-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-03",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT209962",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61049864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Caring Community (Josephine at Home)
• Josephine Caring Community (Josephine At Home)
• Thomas Jung, THOMAS JUNG
• Kelsey Nichole Kanehen
• Timothy John Kathol
• Emily Josephine Kelley-Brown, MPH, RD, CD, CSP
• Debra R Kennedy, RN, LMP
• Margaret Erskine Kepler, M.D.
• Kevin Lee DDS Johann Ti DDS & Michael Hyodo DDS PLLC (Stanwood Dental Care)
• Lynda I Khisa

• Pediatrics Physician in Stanwood, WA
• Providers in Stanwood, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.