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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KETRAH DEKANICH
NPI 1497569107
General Practice in Tacoma, WA

Active since February 03, 2025
9040 JACKSON AVE, TACOMA, WA 98431(253) 968-0117 Get Directions Write a Review

NPPES record last updated: September 21, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 21, 2026, Feb 3, 2025 (2 updates tracked since 2025).

About Ketrah Dekanich NPPES

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

KETRAH DEKANICH (NPI 1497569107) is an individual general practice provider in Tacoma, Washington, licensed in Virginia (0101290495) and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1497569107
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameKETRAH DEKANICH
Location Address9040 JACKSON AVETacoma, WA 98431-0001
Mailing Address9040 Jackson AveTacoma, WA 98431-0001 · (253) 968-0117
Phone(253) 968-0117
Sole ProprietorNo
Enumeration DateFebruary 3, 2025
Last NPPES UpdateSeptember 21, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 21, 2026
✔ NPI 1497569107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in VA · 0101290495
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
9040 JACKSON AVE, Tacoma, WA 98431
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Other Providers at the Same Location NPPES 20

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

MICHAEL JOHN MEANS CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2235
DR. ADAM CLAY PERKINS PH.D.
Psychologist (Clinical)
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-3071
GABRIELLE ABRAHAMSEN DPT
Physical Therapist
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2220
KENNY VAN LE MD
Anesthesiology
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-1110
MR. ANDREW J IRIZARRY DNP, CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (330) 509-3934
MATTHEW LIBID CRNA
Nurse Anesthetist, Certified Registered
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (203) 768-5053
DR. SALEEM M CHOUDRY
General Practice
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-2462
COURTNEY LAVIN
General Practice
9040 JACKSON AVE
TACOMA, WA 98431
Pierce County (253) 968-1790

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 Ketrah Dekanich's NPI number?

The NPI number for Ketrah Dekanich is 1497569107. It was assigned to this individual provider in the NPPES registry on February 3, 2025.

Where is Ketrah Dekanich located?

Ketrah Dekanich practices at 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (253) 968-0117.

What is Ketrah Dekanich'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 Ketrah Dekanich was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.