CLYDE HARRY KOONTZ MD NPI 1184617607

NPI Information

NPI: 1184617607
Provider Name: CLYDE HARRY KOONTZ, MD
Classification: Internal Medicine - 207RC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

Address:
316 MARTIN LUTHER KING JR WAY
SUITE 401
TACOMA, WA
ZIP 98405
Phone: (253) 572-5140
Get Directions

Clyde Harry Koontz, MD is a critical care medicine internal medicine in Tacoma, WA. The provider is an internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. Clyde Harry Koontz, MD NPI is 1184617607. 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:

316 MARTIN LUTHER KING JR WAY
SUITE 401
TACOMA, WA
ZIP 98405-252
Phone: (253) 572-5140
Fax: (253) 272-0419

The enumeration date for this NPI number is 8/30/2005 and was last updated on 9/12/2008.

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		14794	WASHINGTON	No
2	207RP1001X	Internal Medicine	Pulmonary Disease	14794	WASHINGTON	No
3	207RC0200X	Internal Medicine	Critical Care Medicine	14794	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G8805653-KING CO	MEDICARE PIN	WASHINGTON
2	13531-01	MEDICAID	WASHINGTON
3	G001000602-PIERCE CO	MEDICARE PIN	WASHINGTON
4	756291101	OTHER	WASHINGTON	RR MEDICARE

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: 11/14/2023

NPI Synchronization or Removal

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