DR. KEITH TED CHAN (NPI# 1295001972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295001972 |
| Entity Type | Individual |
| Full Name | DR. KEITH TED CHAN |
| Credential | MD |
| Practice Address |
1304 Fawcett Ave Ste 100 Tacoma WA 98402-1900 |
| Practice Telephone | 2537614200 |
| Practice Fax Number | 2537614201 |
| Mailing Telephone | (253) 761-4200 |
| Mailing Fax Number | 2537614201 |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD60384220 | WA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ML 60286792 | WA | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
MD60384220 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2019235 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2202 S Cedar St Ste 200, Tacoma, WA 984052318 | 2537614200 | 2537614201 |
| 2502 S Union Ave, Tacoma, WA 984051328 | 2537619482 | 2537596252 |
| 222 15th Ave Se, Puyallup, WA 983723754 | 2538414353 | 2535838630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376781799 | Keith Ming Chan | Physical Therapist | 241 Condo Ln Apt 602, Tamuning, GU 96913-3144 | 2009-01-22 |
| 1548452782 | Keith Wei Chan | Orthopaedic Surgery | 2725 Capitol Ave, Suite 302, Sacramento, CA 95816-6004 | 2007-08-13 |
| 1124147012 | Keith C Chan | Radiology | 4045 E Bell Rd, Suite 143, Phoenix, AZ 85032-2236 | 2007-03-29 |
| Street Address |
1304 FAWCETT AVE STE 100 |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598746232 | Joon Kyung Song | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2005-11-09 |
| 1487179404 | Trevor Lee Reeves | Physician Assistant | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2017-08-10 |
| 1699228536 | Bridget Ann Lonergan | Registered Nurse | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2016-07-27 |
| 1508213042 | Amanda Maureen Brown | Physician Assistant | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2016-05-14 |
| 1841658598 | Gensuke Akaike | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2016-02-09 |
| 1437577723 | Daniel Van Roekel | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2014-04-03 |
| 1912325473 | Nicholas Zane Conley | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2014-04-02 |
| 1619395100 | Sandhya Jacob | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2014-04-01 |
| 1285060426 | Christopher James Schaller | Physician Assistant | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2013-09-19 |
| 1841553088 | Mark Aaron Broadbent | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 | 2012-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841310323 | Timnit Ghermay | Radiology | 1201 Pacific Ave, Suite 400, Tacoma, WA 98402-4301 | 2007-03-30 |
| 1750538252 | Benjamin James Jabara | Radiology | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-5000 | 2008-08-26 |
| 1891968392 | Charles Aaron Kitley II | Radiology | 9040 Jackson Ave, Tacoma, WA 98431-2028 | 2008-04-07 |
| 1497744379 | Andrew H Hardy | Radiology | 1304 Fawcett Ave, Suite 100, Tacoma, WA 98402-1911 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497318588 | Stephanie Sobrepera | Radiology | Radiology Department Rr 210 1959 Ne Pacific Street, Seattle, WA 98195-3450 | 2019-04-15 |
| 1104236322 | Thomas John Kofler | Radiology | 1301 Willard Ave W, Seattle, WA 98119-3460 | 2014-04-28 |
| 1689991655 | Zachariah Kramer | Radiology | 700 Lincoln Street Suite 100, Longview Radiologists, Kelso, WA 98626 | 2010-04-29 |
| 1235368564 | Lakhwant Singh | Radiology | 2916 Nw Bucklin Hill Rd #381, Silverdale, WA 98383 | 2009-07-08 |
| 1902870827 | Overlake Imaging Associates PC | Radiology | 1417 116th Ave Ne Ste 212, Bellevue, WA 98004-3821 | 2006-02-15 |
| 1740268325 | Mark D. Papenhausen | Radiology | 3216 Norton Ave, Suite 201, Everett, WA 98201-4290 | 2006-01-04 |
| 1942287859 | Louis I. Juravsky | Radiology | 2412 N 43rd St, Seattle, WA 98103-7644 | 2005-12-30 |
| 1811974652 | Thomas Kieran Curry | Radiology | 1450 5th St Se # 220, Puyallup, WA 98372-4602 | 2005-12-22 |
| 1679193205 | Sound Vascular, P.s. | Radiology | 32014 32nd Ave S, Federal Way, WA 98001-9625 | 2020-04-23 |
| 1003252776 | Provascular Diagnostic and Imaging Pllc | Radiology | 202 N Division St, Suite 200, Auburn, WA 98001-4939 | 2013-05-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.