DR. GLENN J. KIETZER MD
NPI 1003847179
General Practice in Tacoma, WA

Q: What is Glenn Kietzer's NPI number?

The NPI number for Glenn Kietzer is 1003847179. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Q: What is Glenn Kietzer's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Glenn Kietzer was last updated on May 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 06, 2006

15005 PACIFIC AVE, SPANAWAY GENERAL MEDICAL, TACOMA, WA 98444(253) 537-3724(253) 537-6425 Get Directions Write a Review

NPPES record last updated: May 7, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Glenn J. Kietzer Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLENN J. KIETZER MD (NPI 1003847179) is an individual general practice provider in Tacoma, Washington, licensed in Washington (MD00009584) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1003847179

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. GLENN J. KIETZERCredential: MD

Location Address15005 PACIFIC AVE, SPANAWAY GENERAL MEDICALTacoma, WA 98444

Mailing Address15005 Pacific Ave, Spanaway General MedicalTacoma, WA 98444 · (253) 537-3724 · Fax (253) 537-6425

Phone(253) 537-3724

Fax(253) 537-6425

Sole ProprietorNo

Enumeration DateJuly 6, 2006

Last NPPES UpdateMay 7, 2014

✔ NPI 1003847179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in WA · MD00009584

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

15005 PACIFIC AVE, Tacoma, WA 98444

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Other Identifiers 3

Medicare ID-Type UnspecifiedAB03343

Medicaid1195601WA

Medicare UPINA04892

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN PATRICK MAIORCA MD

General Practice

15005 PACIFIC AVE, SPANAWAY GENERAL MEDICAL CLINIC
TACOMA, WA 98444

Pierce County (253) 537-3724

SPANAWAY GENERAL MEDICAL CLINIC

General Practice

15005 PACIFIC AVE, SPANAWAY GENERAL MEDICAL CLINIC
TACOMA, WA 98444

Pierce County (253) 537-3724

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Kietzer's NPI number?

The NPI number for Glenn Kietzer is 1003847179. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Glenn Kietzer located?

Glenn Kietzer practices at 15005 Pacific Ave Spanaway General Medical, Tacoma, WA 98444. The listed phone number is (253) 537-3724.

What is Glenn Kietzer's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Glenn Kietzer was last updated on May 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.