Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kenneth Wayne Kooser, MD

Individual provider Family Medicine Physician · NPI 1306920772

Dr. Kenneth Wayne Kooser, MD is a Family Practice in Lacey, Washington. Graduated from University of Washington School of Medicine in 1999, 27 years ago. Practices with Providence Health and Services Washington, a 480-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
27
Trained at
University of Washington School of Medicine
Licensed in
WA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4800 College St SE
Lacey, WA 98503-4389
Phone: (360) 486-2900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD60320788 (WA)

Record details

NPI number1306920772
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 24, 2006
Last updated in NPPESJune 16, 2021
Certification dateJune 16, 2021
Mailing addressPo Box 3360, Portland, OR 97208-3360

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 1999 (27 years in practice)
Group practice Providence Health And Services Washington — 480 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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