Individual
EDWARD J KNOLL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 MERIDIAN S, SUITE B, PUYALLUP, WA 98371-6995
(253) 845-9511
(253) 840-3513
Mailing address
800 MERIDIAN S, SUITE B, PUYALLUP, WA 98371-6995
(253) 845-9511
(253) 840-3513
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
MD00015770
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0164016
WORKERS COMPENSATION
WA
05
—
8322133
—
WA
01
—
KN3909
REGENCE BLUESHEILD
WA
Enumeration date
07/20/2005
Last updated
07/08/2007
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