# MELISSA SUE KNUTSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568790046
- **Gender:** F
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 34009672 | OH | — |
| 207Q00000X | Family Medicine Physician | DO157503 | OR | Yes |

## Other

- **Enumeration date:** 11/23/2009
- **Last updated:** 05/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10024004 | WV BWC | WV |
| 01 | — | 3029332 | MOLINA | OH |
| 05 | — | 3029332 | — | OH |
| 05 | — | 3810017114 | — | WV |