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

Keith E Petersen, DO

Individual provider Adult Medicine Physician · NPI 1356615470

Keith E Petersen, DO is a Family Practice in Tacoma, Washington. Qualified in 2012, 14 years ago. Practices with Multicare Health System, a 2,302-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
14
Licensed in
WA
In the registry since
2012
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

9040 Jackson Ave
Tacoma, WA 98431-1000
Phone: (253) 968-1340
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X · Licence 60595760 (WA)

Record details

NPI number1356615470
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 7, 2012
Last updated in NPPESMarch 12, 2024
Certification dateMarch 12, 2024
Mailing address9040 Jackson Ave 9040 Jackson Street, Tacoma, WA 98431-1000

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Multicare Health System — 2302 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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