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Deactivated NPI 1235121054 Deactivated / Inactive NPI Male Practitioner

Dr. Keith Benoit Tucker , MD

General Practice • Anacortes, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Keith Tucker has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 17, 2005
NPI Deactivation Date September 15, 2020
Total Practice Duration ~15 Years of Practice (2005 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Keith Tucker, MD was a registered General Practice practicing in Anacortes, WA. Throughout an active medical career spanning 15 years, Dr. Tucker provided care at the practice location at 2918 COMMERCIAL AVE until profile deactivation on 2020-09-15.

Practice Location & Contact Primary Location

Practice Address

2918 Commercial Ave

Anacortes, WA 982212738

Telephone 3602936404
Fax 3605889537
Associated Practice Facility / Clinic
🏢 Samish Indian Nation Facility NPI 1790942902

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Anacortes, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 30.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Anacortes, WA (423 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License WA MD00008015

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 15, 2020

Record deactivated on September 15, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2918 COMMERCIAL AVE, ANACORTES, WA 982212738 (Tel: 3602936404)

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Updated Business Mailing Address July 08, 2007

Registered at 2918 COMMERCIAL AVE, ANACORTES, WA 982212738 (Tel: 3602936404)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KEITH TUCKER, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

General Practice (License #MD00008015 in WA)

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Initial NPI Registration & Enumeration August 17, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235121054
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 17, 2005
Last Update: July 08, 2007
Deactivation Date: September 15, 2020

Mailing Address

2918 Commercial Ave

Anacortes, WA 982212738

Phone: 3602936404

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.