Individual
MARY KNOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15290 SW ROYALTY PARKWAY, PORTLAND, OR 97224
(971) 256-4047
Mailing address
3117 MAIN ST APT 348, PHILOMATH, OR 97370-2148
(702) 686-0140
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
04/18/2022
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