Provider Demographics
NPI:1740254283
Name:KATSMAN, RALPH J (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:J
Last Name:KATSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 S CEDAR ST STE 330
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2202 S CEDAR ST STE 330
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2318
Practice Address - Country:US
Practice Address - Phone:253-272-5127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030895207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8147894Medicaid
WAMD00030895OtherWA LICENSE
WAMD00030895OtherWA LICENSE
WAG8851595Medicare PIN
WAG8880511Medicare PIN
WAG8851596Medicare PIN
WAAB07213Medicare PIN
WAG8851597Medicare PIN
WAG8851594Medicare PIN
WA001045700Medicare PIN
WA8147894Medicaid
WA8851594Medicare PIN
WA000188100Medicare PIN