Individual provider Active NPI

Joshua Ikaika Keanu, PA-C

  • Medical Physician Assistant
  • Puyallup, WA
National Provider Identifier
1952950412
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61120788 Issued in WA
Practice address
4505 S Meridian Ste a
Puyallup, WA 98373-5002
Phone
(253) 697-5770
NPI assigned
Sep 8, 2019
Last updated
Dec 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA61120788 WA Primary

Addresses

Primary practice location

4505 S Meridian Ste a
Puyallup, WA 98373-5002

Mailing address

4505 S Meridian Ste a
Puyallup, WA 98373-5002
Phone (253) 697-5770

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210111001328 WA Practitioner - Physician Assistant 9638582745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

345 Cooper Point Rd NW
Suite 103
Olympia, WA 98502-4461
Phone (360) 763-7515

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA61120788WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 28, 2025 Accepting new patients
Multicare Health System CurrentSince Aug 28, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 5, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Jan 5, 2021 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: jkeanu856288@direct.multicare.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1952950412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 S MERIDIAN STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735002",
            "telephone_number": "253-697-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 S MERIDIAN STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735002",
            "telephone_number": "253-697-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANU",
        "first_name": "JOSHUA",
        "middle_name": "IKAIKA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-08",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61120788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.