Healthcare Provider Details

I. General information

NPI: 1528705118
Provider Name (Legal Business Name): KATHRYN KEYS ANNAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 31ST AVE SW
PUYALLUP WA
98373-3723
US

IV. Provider business mailing address

3908 10TH ST SE
PUYALLUP WA
98374-2188
US

V. Phone/Fax

Practice location:
  • Phone: 253-848-5951
  • Fax: 253-845-7073
Mailing address:
  • Phone: 253-848-5951
  • Fax: 253-845-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD70021305
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: