DR. TYLER GARRETT KETTERL M.D. NPI 1205128543

NPI Information

NPI: 1205128543
Provider Name: DR. TYLER GARRETT KETTERL, M.D.
Classification: Pediatrics - 2080P0207X
Entity Type: Individual

Specialization: Pediatric Hematology-Oncology

PECOS Registration: Yes

Address:
4800 SAND POINT WAY NE, MS: MB.8.501
SEATTLE, WA
ZIP 98105
Phone: (206) 987-2106
Get Directions

DR. Tyler Garrett Ketterl, M.D. is a pediatric hematology-oncology pediatrics in Seattle, WA. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. DR. Tyler Garrett Ketterl, M.D. NPI is 1205128543. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4800 SAND POINT WAY NE, MS: MB.8.501
SEATTLE, WA
ZIP 98105
Phone: (206) 987-2106
Fax: (206) 987-3946

The NPI 1205128543 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/4/2011 and was last updated on 3/29/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		MD60552603	WASHINGTON	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	2080P0207X	Pediatrics	Pediatric Hematology-Oncology	MD60552603	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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