Individual
KEITH M GAUTREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 SE BISHOP BLVD STE 401, PULLMAN, WA 99163-5517
(509) 336-7720
(509) 715-2131
Mailing address
915 NE VALLEY RD, PULLMAN, WA 99163-3845
(509) 332-3548
(509) 332-5253
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
24201
NE
207Q00000X
Family Medicine Physician
Primary
MD60322685
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2025117
—
WA
01
—
P00419700
RR MEDICARE
NE
Enumeration date
09/13/2006
Last updated
07/09/2025
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