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NPI Code Detail

MEDICARE: ALEXANDER EVAN KETTERING MD

MEDICARE: ALEXANDER EVAN KETTERING MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist PhysicianMD61421223WA
2207R00000XInternal Medicine PhysicianMD61421223WA

General Provider Information

NPI Number : 1548898828
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER EVAN KETTERING MD
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1959 NE PACIFIC ST
Second Line :
City : SEATTLE
State : WA
Zip : 98195-0001
Country : US
Telephone Number : 206-520-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2020
Last Update Date : 12/10/2025

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Directions to “ ALEXANDER EVAN KETTERING MD” Practice Location

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